With all this in mind, upon the teacher's request for testing, I made an appointment with one of the professionals whose name was provided by the Principal, and with Doug's pediatrician as well, to rule out any possible physical causes.

We saw the pediatrician first, who was aware of the purpose of out visit. He didn't so much as take Doug's temperature, but immediately launched into a speech about how he thought he "has" ADD, and he thinks his adult son "has" ADD, and how medication would have helped, and blah, blah, blah. He was ready to write a prescription right then if I wanted. When I resisted and indicated that I really wanted to scrutinize the situation more closely before resorting to medication, he lost interest and spoke vaguely of referring us to a psychiatrist, if our insurance would allow it.

Then we saw the psychologist. I was somewhat apprehensive when I called to make the appointment, as choice number one on the voice mail is the "ADD Clinic," but I tried to keep an open mind. This doctor did spend about 1 1/2 hours with us total which was divided between time alone with my husband and I, and time with Douglas and my husband and I.

It was very obvious that this doctor's philosophy was "if you're here, it must be ADD." He asked a lot of questions and took a lot of notes, and to just about any comment from us he'd say "Ah yes, that is typical of ADD," or "You sometimes see that in ADD." He then recommended a battery of tests with which he claimed they are able to diagnose ADD with about 95% accuracy (or something like that).

We did make an appointment for the testing, which I then cancelled. I was appalled at the ease with which these people were willing to label my son as disabled and put him on drugs. I had also begun doing some research, your book as well as others, and it has become obvious that we needed to exercise caution in pursuing this matter.

I question the wisdom of testing and labeling a child so young. I feel that labeling a child does nothing but lower everyoneís expectations for that child, and it is impossible to get that label removed once it is given. In addition, the school has no special services available for "identified" kids, so I am not sure what is to be gained.

I also am not in favor of medication unless absolutely necessary. I have always said that Douglas is a clone of his Dad, but without the self-control. My husband recalls having many of the same problems and getting the same comments as Douglas when he was a child. Fortunately, my husband is a very successful adult. I expect Doug will be, too, given the opportunity to learn to manage, direct, focus and control his energy and impulses. I question whether Doug could learn the necessary skills of self-control if he were medicated. Also, there is a history of tic disorders in my husband's family, which also concerns me.

At home we find Douglas challenging, but manageable. He does his homework every night, albeit under duress. We use a check system to reward desired behaviors. He is a very loving, compassionate, expressive, verbal child, but also has a nasty temper when angered. His behavior has improved tremendously with each passing year. In the past I used to find it overwhelming to be left home alone for any length of time with both kids, Douglas in particular. Now, it is not a problem. It is enjoyable to be home with either one of them alone. I find the sibling bickering to be the worst part of being with both the kids. Douglas still, however, will often talk non-stop when he is with an adult. Usually asking many, many questions about endless subjects (often science related, which is his special interest).

We know Doug is an intense, persistent, energetic, "behaviorally challenged" child, and it is imperative that he learn to control his behavior and focus his energy. What we are trying to determine is if we are dealing with a chronic problem that requires intervention, or a temporary one that can be handled with cooperation between the school and ourselves. We are willing to consider holding Douglas back if necessary, and we are hoping the school is willing to consider moving Doug to another teacher if that looks like the best option.

If it is decided that it is necessary to pursue testing for Douglas, we want to feel confident that all of the foregoing will be taken into consideration, that the diagnosis and treatment plan are not a foregone conclusion before we walk in the door, and that a variety of treatment options will be presented if appropriate.

As I said, we are hoping that you can refer us to someone in our area who can meet our criteria.

I can understand why you liked Running on Ritalin because I really appreciated and liked your email (as lengthy as it was) because you really describe your son (strengths and weaknesses) and recognize that the environment within which he operates also can contribute to "the imbalance" that is the basis for the complaints and problems surrounding his behavior (a real long sentence my editors would never let me get away with in a book). Anyway, I was particularly touched by your experience with the pediatrician and the ADD expert. I think your insights were absolutely right on for both. I must say even I start the view the world through ADHD glasses after awhile. I've even told adult patients that thirty years ago doctors would have viewed their problems as parent-child relationship issue (e.g. now pleasing father,etc.). Now it's viewed as biological and having nothing to do with dad.

Obviously both are important but the swing has been major and affects even me -- only I recognize it and share the bias with the patient as opposed to stating "This is THE TRUTH!" As you can tell this gets me a bit riled (especially the truth part since I can't stand hubris in anyone, especially doctors and lawyers). Anyway I have a name for you in Orange County. Ronald Kotkin is a psychologist and special education consultant associated with the Child Development Center at UC Irvine (the group is headed by Jim Swanson who is world famous). I'd call Ron directly and mention me. He probably doesn't do evaluations but could refer you to someone who might be more sensitive to the larger picture. Make sure you get your point of view across to him over the telephone - he'll get it (and you're pretty articulate - at least on email). Let me know how it goes and good luck in any case.