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I was hoping to bounce some ideas off of you. Some recent behaviour issues have had be coming back to a consideration of the possibility that my son has ADHD. His teacher thinks he is fine, and my husband thinks I am overanalysing everything. So I feel a bit like the line from Zoolander "I feel like I am taking crazy pills" where no one else sees something that is starting to look obvious to me. Here are a few of my concerns, keep in mind that my son is still only 5.5, and maybe he will grow out of some of this. Also please share what concerns made you seek assessment for your child.

On his IQ test he had a verbal score in the 150s and a processing speed of 118. There is a big discrepancy between a reading comprehension test administered privately which had him hitting the ceiling of the test with comprehension of at least 3rd grade and the school administered test that puts him mid 1st grade. I tend to agree with the teacher's assessment, but his reading accuracy is at a 4th grade level, and I think there is a big gap in his oral verbal ability and reasoning, his reading accuracy, and how he seems to do with reading comprehension, which to me indicates that there might be some sort of problem slowing down his reading comprehension.

And thinking about it now, he has trouble with memory recall. I have had times when I ask him things, and he says he doesn't know, but when I give him a slight trigger for the memory, the information is there, he just seems to have trouble grabbing the correct information without a bit of a prod.

DS has never been able to sit still. He constantly gets up from the dinner table. He had trouble sitting on the mat for news time at daycare last year. Even when I am reading him a story at night he tends to be fidgeting away.

He really struggles to keep his hands off things. He is into drawers he knows he is not allowed to be, he grabs things off the kitchen counters. When we are doing something together on my computer and I ask him not to touch the keys he keeps hitting them anyway.

He talks constantly and has a hard time not answering questions which are directed at his sister.

Getting dressed in the morning has been a battle for years now. I remember one day when he got wet at the park and I asked him to change when we got home he got upset and said, I am so bored of having to get dressed all the time. He swings his clothes around his head, or walks off to start doing something else.

He is very disorganised and often comes home missing some of his things.

He can rarely self entertain.

he rushes through worksheets and often fails to read instruction properly.

He rarely finishes things he starts, be it a game or activity he has picked or something I had asked him to do.

he tries to avoid anything that involves any amount of effort.

Even if he is working on something that he really enjoys, he gets distracted very easily by what is going on around him.

In extracurricular activities he seems to have trouble focusing too. In swimming class he gets in trouble and has to sit on the side of the pool because he will be jumping off the podium or moving all around when it is not his turn. When he was in dance class, all the kids would be lined up and he would be at the lockers at the back of the classroom getting his hands on to anything he could find. He liked the class, but if he wasn't actually the one doing the dancing at any given time he was all over the place.

Sometimes its really hard to get him to pay attention to me when I am trying to talk to him.

In your opinion, is some sort of assessment warranted to look for possible ADHD or maybe some other learning challenges that his strengths might be masking?

I'd look into it.

So I have two college kids who were both diagnosed as gifted in midschool but were never diagnosed with ADHD until college. Both did fine, competed in sports, did well enough in school without any effort and never triggered a concern from me. It wasn't until college with the classes were so much harder and time-intensive, their schedules so much more complex that they started to fail. Since being diagnosed, they both have gone from struggling to maintain grade levels high enough to not get kicked out of college to getting all A's and B's - in engineering.

My youngest has been tested twice and had ADHD ruled out despite having several of the symptoms. Disorganization, distraction, failure to sit still, impulsive interjections, etc. can all be attributed to so many other things besides ADHD.

At 5, he's also dealing with a racing mind from his high IQ and not being able to have his body keep up with his mind at times. That can cause a lot of what you're describing.

If he is failing in school or constantly getting in trouble, it would be worth seeing a qualified pediatric psychologist to express your concerns. But if he isn't failing, I personally would leave it a lone and just take note of the behaviors and see what makes them worse, better, when they go away or show up - and see if you see patterns. It will help you understand how to help your son better manage those situations and will also be very helpful should you decide to pursue a diagnosis.

My DS is older (just past 7th birthday), but doesn't have that type of ADHD--his is more the inattentive space cadet version (although at times he can be hyper). I'm not 100 percent sure my DS has ADHD but a trial of meds seems to be helping the focus issues at school. DS is like an absent-minded professor. Your DS sounds more hyper-impulsive type.

DD (age 8) has combined type, so she is both inattentive and hyper/impulsive. Strangely, she seemed actually more in control of herself and a better listener than other kids when she was a toddler. When she was around 4, I noticed she was more wiggly than other kids and wasn't always listening during "circle time". She was constantly touching other kids, or she'd take off and run down the hallway at preschool when they were supposed to be walking. She was super slow with things like getting her coat, boots, mittens on when it was time to go home, usually the last kid to get ready. Everyone else would be ready and lined up, and she'd still be sitting there putting on her snowpants. In kindergarten, she had a problem with written work and was very slow to get things done, but I don't think that's always the case with ADHD (some kids rush through things). I suspect DD may have a LD in terms of writing and it's hard to sort out what is ADHD and what is a LD. Shortly after her 6th birthday she was in first grade, and still really slow with unpacking her backpack, getting into class, getting organized, etc. She would be chatting in the hallway with random kids or teachers rather than doing what she was supposed to do. At times she would do weird, impulsive things like break crayons in half on purpose, or wash her hair in the sink because she decided she was hot or sweaty. In school, she didn't seem particularly hyper, which probably delayed the diagnosis and the teacher saying anything about her. She did seem hyper in gymnastics class, though, and very excitable. She would swing from bars she wasn't supposed to swing from and was just generally off-task. The coach refused to move her up a level, saying DD was too whipped up and it was a safety issue.
After we medicated her we saw a big difference in school. Now it's two years later and she is still very difficult when not medicated. She has slow processing speed, even with meds, so that is an ongoing issue. Her processing speed score was only 93 but her GAI on the WISC was 150+

My advice would be to seek a broad evaluation - neuropsych or educational eval - rather than an ADHD-specific evaluation, because some of the things you've mentioned sound more like LD-type challenges, and some of the fidgety-ness and inability to focus *could* be ADHD or they *might* be due to a different type of challenge. There's most likely a clue in the gap in scores on your ds' WISC testing - but he'll most likely need some more testing plus a good look at developmental history to determine *why* there is the gap.

Please note - I am *not* parenting a gifted child with ADHD - but when they were your child's age, two of my children had behaviors that *looked* very much like ADHD. Your ds especially has a lot of things in common with my older dd when she was your ds' age - and she was a child that other people would look at and think she was obviously ADHD - even her ped was convinced she had ADHD - but in reality, she had a vision issue. She also had the large gap in PSI on her WISC - which was due to the vision issue. After she went through vision therapy and no longer had double vision and tracking issues, her focus and ability to follow multi-step directions improved tremendously.

Re the reading tests - when you're trying to chase down the cause of differences in tests like this, it's important to look at every single bit and piece of info you have about the test - not just what it was testing, but how was it administered (were the instructions given orally, did your ds reply orally or with handwriting, was it timed, etc). Did the test include visual cues? My dd with the vision problem scored really low on a cognitive test when she was little, so she was referred for further testing due to concern that she was cognitively impaired (this was through the school district at 3 - which meant she scored below the 25th percentile in whatever cognitive assessment they used as a screener) - then she aced the more in-depth eval the district gave her. I walked away from that whole thing feeling like an idiot parent! It wasn't until years later when we she was finally diagnosed with her vision challenge that I realized the difference in scores wasn't due to her actual IQ/ability - it was due to the way the tests were administered - the first test was questions cued from a set of visual cards, the second eval was all oral questions.

The other thing with reading evals is that reading requires a large number of very specific skills - so a little something off in one area could throw one test off but not another - we've seen this with my 2e dd who has a challenge with a certain type of memory that impacts her ability to associate sounds with letter symbols. We knew from an educational eval that she had the memory challenge, but it took an incredibly detailed and thorough reading assessment by a reading specialist to really understand the impact of the challenge on her reading skills. The thing is, I wouldn't want to go into that type of a specialist eval (reading or otherwise) without first having the comprehensive eval when there are the variety of things going on that you've mentioned above.

Best wishes,

polarbear

Thanks everyone

polarbear - I think you are right. I was considering a full evaluation, I was even thinking of waiting until he is 6 so that he could do the wisc as the wppsi did not have a section specifically for working memory.

I have been hesitant to think too much about ADHD as there is so much overlap with gifted behaviour traits, but if reading comprehension is going to be an issue, that is best addressed earlier as it will have effects across all of his education. It is not a huge issue this year, and I can see the school not even taking it seriously as he is in kindergarten and reading at a 1st grade level. But the teacher said as soon as the test went beyond the level with picture support, he struggled to answer closed questions. So it sounds to me like there is definitely something going on, be it ADHD or something else. He is very bright verbally, he is able to read with the accuracy/fluency of a fourth grade student, surely he should be able to comprehend at a level higher than 1st grade?

some google searches on adhd and reading comprehension seem to say it is a common symptom and some of the signs were things DS does, like skipping words, substituting a different word with the same meaning, and reading very quickly.

Frankly, a lot of schools seem to be invested in NOT having children move too far ahead of the class, so I take their comprehension levels with a grain of salt. For example, our school seems to cap off reading levels at one grade level ahead. My DS7 reads high school/college level non-fiction and at least 4th-5th grade fiction at home, and at his school they assure me he is only comprehending on a mid-second grade level (he is in 1st), even though his DRA is by their measure at the end of second/beginning of third grade level and he frequently talks to me in detail about the books he is reading. It has become quite obvious to me over the past two years that he will not be allowed to get more than one grade level ahead. It just WILL.NOT. HAPPEN.

Part of the issue for your son may be the actual reading comprehension test the school uses. After a certain point, the DRA requires written answers, not oral, and it can be difficult for some younger students, no matter how bright.

Some of the other behaviors sound typical for 5.5, but pursue an evaluation if you think it is necessary.

thanks momoftwins

I could be wrong, but I don't think his teacher was trying to cap his achievement. She said she started at a level 30 which I assume was where she estimated he would be. She said she moved backwards level by level, until she hit a level 21, which involves visual cues. I will ask her at the meeting we have scheduled in a couple of weeks whether she had thought he would score higher or not from his fluency. But also, from my own experience with trying to probe his comprehension, I had questions over his comprehension. I was relieved at the private assessment that showed he was comprehending a lot, but I find the teachers' assessment more consistent with my own experience working with him.

I agree that all the behaviours are typical for a 5.5 year old. I guess it is a matter of extent and frequency. Maybe it would be better to wait 6-12 months and get further evaluation done if his behaviours appear not to be ageing appropriately with him, and his reading comprehension doesn't seem to be improving.

He is too young for an ADHD diagnosis - he may be given one but a lot of the behaviors that a justifiably of concern at 8 are normal at 5. A lot of them sound familiar too - some kids need more support to stay on task than a teacher is able to give.

I would second polarbear's recommendation. Instead of looking purely at ADHD, you would probably be better off looking at a comprehensive evaluation, as children tend to display the same symptoms for a wide range of challenges (due to their smaller repertoire of coping skills). If you want to know about working and other memory, there are other scales that will go down to age five (i.e., you don't need to do the WISC to get working memory info), many of which will give you much more in-depth info on his memory profile. I like the WRAML-2 (Wide Range Assessment of Memory and Learning) and the CMS (Children's Memory Scale). Another advantage of this approach (WPPPSI and WRAML/CMS) is that, in the event that ADHD really is involved, and he gets put on meds, you will still have the option of doing a re-test with medication more or less immediately, using the WISC-IV or -V, rather than having to wait for two years.

FYI, there is no formal lower limit on ADHD diagnosis, though many practitioners are reluctant to diagnose and medicate in pre-elementary children, due to the wide range of normal in preschoolers. The actual age-restriction is that symptoms need to have been first reported in childhood, not appearing suddenly in adulthood. (It used to be before age seven; now it's before age 12.)