Gifted Issues Discussion homepage Forums Twice Exceptional ADHD based on scores?

I don't know enough about your dd's specific challenges to know if this will work, but for our ds a large part of the key was repeat, repeat, repeat... and then repeat again. For instance, he seemed to be hopelessly disorganized about getting what he needed from school to home and back (books needed for homework were often forgotten at school, homework assignment list not recorded so he didn't know what he was supposed to be doing for homework once he was home, completed homework going into his backpack but getting completely lost between the backpack and school, things like that). What we did was for me to physically go inside the school each day at the end of the day to pick him up, we checked the homework list on his classroom board together, went through his locker to make sure he had everything he needed (verbally went through the entire list of his classes together - what did they do in class today, what was the homework, what did he need to bring home to complete it). I made sure that his locker was left neat and in order. I did this with him every single day for almost the full first year of middle school - and as you might guess, he hated it! But he also realized after a relatively short period of time that it was helpful. I promised him that once he was able to show me that he was doing the organizing etc instead of relying on me to lead, I'd step back and only come in once per week, and knowing that gave him the motivation and self-confidence that I believed it would work. It took a long time - most of the year, but he got to that point. We continued with once a week checks through the first part of the next year, and he eventually got to the point that he no longer needed my help.

It's not uncommon for challenges such as this to seem to have a genetic component. One thing that's potentially an upside to this is that it's something you can share with your dd - you have an understanding of what it's like to live with her set of challenges. On the other hand, it's often so easy to see ourselves (parents) reflected in our children that we miss seeing something different. Prior to our ds' 2e diagnosis, my dh and I both tended to look at behaviors which were indicating challenges through the lens of our own lives - I was a perfectionistic in school (and life) for a long time, so when my ds wasn't completing assignments in a timely manner, I made the automatic leap to perfectionism - I was, he's mine, therefore he's got my whatever, case solved. When really we were missing something that neither of us (parents) had as a challenge.

I would expect this is an accommodation you could request in a 504 plan - although my ds doesn't use this specific accommodation in school, he is allowed the use of assistive technology through his 504 plan. Electronics and phones in general aren't allowed at school due to the potential distraction, but they are commonly used as AT devices.

DD's lowest score in the WISC was 94 for processing speed and working memory was around 126 or 127. However, she is a pretty extreme in terms of focus issues. It can take her 3X longer than anyone else to do a math test, even if she ultimately scores very well. Every time Dh or I have entered or exited the school building when she is in class, I can count on her to say later on "Hey, I saw you walk out of the school building (out the window) while I was in math (or reading or writing), what were you doing?" She is actually much more scattered when she is not medicated. One day I forgot her meds and when I realized they were still on the table, I emailed 2 teachers asking if I should bring them in and within 5 minutes they both emailed me practically begging me to bring in her meds because she's not able to function otherwise. I don't think absolute numbers on IQ tests (like below 100 or below 85) should be used, but rather, if there are large discrepancies. In DD's case her GAI was 150 and processing speed 94.

The neuropsych gave her a test called "Rey Complex Figure", which assesses EF ability, and her score was pretty bad. Seemed more accurate than the WISC scores in determining poor EF.

Pretty much any calendar app that allows multiple reminders will work. Some possible reminders:
1. at the time the assignment is due (to remind her to turn it in)
2. the day before
3. two days before
4. at weekly intervals before a long-term assignment is due.

For long-term assignments, I would also suggest breaking them down into intermediate steps, and creating deadlines for each of those components, with proportionate consequences of personal significance.

For example, a two-page paper (about 5-7 paragraphs) due in one months might become a series of benchmarks:

week 1: identify topic, complete research, write outline.
week 2: write 3 paragraphs (or one page)
week 3: complete first draft and submit to teacher to review
week 4: complete final draft and turn it in.

You could even make the benchmarks smaller:

week 2 day 1: write one paragraph
week 2 day 2: write second paragraph
week 2 day 3: write third paragraph
week 2 day 4: re-read and mark paragraphs with self-edits
week 2 day 5: revise paragraphs

Even if the EF of her go-to adult resources is not that strong, this can work, as the key is to set up all these reminders at the time the assignment is given, and then let the technology do the reminding along the way. If there is anyone in her life that she feels comfortable with pulling in as accountability for this, she could also share this calendar with that person, and ask them to harass her (I mean reinforce!) about sticking to it.

On caffeine, I don't think there's a huge downside to it, and if you find it helpful for yourself, then it is quite possible she will, too. But I'm not an MD.

CBT can be very helpful for anxiety. If you and she feel comfortable with the psych who assessed her, that might be a good place to begin. If he/she doesn't do it, ask for referrals. You may also ask the adjustment/guidance counselors/social workers/school psychologist in her middle school for referrals to outside providers. They often have a good sense of practitioners in the area who are suitable for young adolescents. It is not unusual for individuals to be in biweekly therapy, and find it effective, though, like many therapies, a little more frequency than that would probably be better. The intensity of it, I think, is not as important as rapport and fidelity.

How do you calculate GAI based on scaled subscores?

My DD's WISC testing showed 4sd difference in her GAI and her Processing speed. Her GAI was 157 (or 170 with extended norms) but processing was 103.
This was a red flag for our Psych who then put us in contact with an ADHD specialist. He ran observations, looked at videos, filled out a million questionnaires and eventually dx her with severe ADHD. In hindsight, it was obvious. He didn't query the IQ scores discrepancy.
We now homeschool and she is medicated which has made a huge difference, but she still needs list, reminders, help with planning and organisation as well as intensive exercise daily. We can do intensive school work in the morning...lots of subjects for about 20-30 mins at a time which helps keep her focused.