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

Hi,

I posted on the general discussion forum but I think this one is the one I really needed:

My 12yo daughter was given WISC-V and the results are the following:
VCI-130
VSI -144
FRI - 125
WMI - 115
PSI-108

FSIQ = 134, 99%ile

The huge difference between VCI-PSI and VSI-PSI (1.5-2 STDs) is supposedly a hallmark of ADHD? She has zero hyperactivity, but inattention issues are rampant... Very sweet and loving otherwise. It doesn't affect her school grades to a very large degree (one or two Bs only, mostly due to missing/incomplete assignments), because she can compensate for it and because I help with non-stop reminders.

What have you done if you have a child like mine? Have you diagnosed, medicated? Have you tried anything caffeine, omega3/6, specific exercise (we do swimming already)?

My younger son hasn't been tested, and he is very bright, but his attention span is vastly different from my daughter - he can concentrate like nobody else, so I don't think this is typical in all intelligent kids.

A relative dip in PSI happens with some students with ADHD, but it can also be due to quite a few other things, or it might mean nothing at all other than a relative weakness in abilities. The tricky thing is that there are other types of challenges which can appear to be inattention when they aren't recognized and accommodated. Has your dd been through an actual ADHD evaluation (which would include behavioral surveys for parents and teachers, plus possibly other types of tests of executive function and attention)?

Best wishes,

polarbear

Thanks for responding!

The psychologist who gave her IQ test didn't suggest that she needed further ADHD testing, even though I asked about it.

Instead he sent me a publication that showed that "average" gifted group of children would score very similarly to my daughter - (VCI 131.7, PRI - 126.4, WMI - 117.7, PSI - 104.3). And I agree that it could be something like that, but...

The reason I even started researching this is that she tends to score significantly worse on the standardized tests like Cogat or Iowa. Some results go as low as 75%ile, suggesting that her academic results at school are more correlated with her WMI/PSI than her other subscores, indicating a potential learning issue. Also, things like her CogAT scores can just jump several stanadard deviations, test to test - one year scoring in 98% percentile on verbal and the next scoring typically - in the 55%. Something is going on....

What do they typically assess during ADHD screening? Would she be able to compensate for it with her high cognitive abilities, masking the problem?

It may or may not reflect ADHD, as there are many possible causes of lowered WMI and PSI. Keep in mind, btw, that there are three main subtypes of ADHD--primarily inattentive, primarily hyperactive/impulsive, and combined. So the absence of hyperactivity is not per se incompatible with ADHD.

I also have a child with some traits of ADHD, but no apparent significant effects on major life functions. Mine has a school history (now we homeschool) of being consistently responsible, high achieving, and socially-adept, but is both distractible and impulsive (and talks non-stop!). I am pretty sure that the main characteristic that would be missing in a diagnosis is pathology--which, of course, is the only one that really matters.

If the inattention and Index discrepancies aren't playing out IRL as restricting her access to anything of current or future importance to her, then it's just another one of those things to know about oneself, and learn to manage. My approach is to make healthy self-care choices, monitor academic progress and general happiness, and admire it as the beauty of human diversity.

Why did you chose to homeschool?

The time at the elementary school was great. She was in the gifted program and enjoyed it tremendously. Switching to the middle school this year brought two unpleasant things - she didn't re-qualify for the gifted program (!?) and the social aspects of being in a larger group of students seriously bother her. I started thinking of switching to a local gifted school (they require 130 WISC as their entrance criteria), but it comes with a lot of complications, such as lack of bus service and the school being somewhat small. We specifically moved to an excellent school district ten years ago (and pay rather large real estate taxes), so it is just difficult to rationalize the move from the best schools in the country to an unknown school with the emphasis on gifted. At least not yet. Homeschooling isn't an option for us - both of us work and I am also in the middle of my doctorate, so not right now.

We tried to do a lot outside of school. Some stuff she enjoys and some she doesn't. She loves music and plays piano beautifully (better than I ever was). She doesn't really like swimming much, but I believe swim team is very important for her overall health so keep pushing it on.

While I am a great supporter of human neurodiversity (my younger son has some Asperger traits which I treasure), I also think that realization of the big dreams and potential that she has is more important here, so I would like to find a way to help get through the confusing middle school years with more confidence in her abilities, focus and sustained attention.

My son has very low PSI & WM scores compared to his VSI & VCI scores. He has never been diagnosed with ADHD nor have I ever heard of such a correlation. There are other tests for ADHD, but I don't know off my head what they are. And no we haven't medicated for it since he wasn't diagnosed.

I have 2 kids both with wide differences between VCI and PSI (and also PRI and PSI - they both did the WISC-IV) neither has been diagnosed with ADHD. DS9 has a 4 SD gap and we started this adventure into gifted because the school was convinced he had ADHD-Inattentive. He's now been through 2 full rounds of testing and both times he didn't come out with an ADHD diagnosis (he does have an LD in written expression though). He also did not test well on the Cogat. This year he moved to a gifted class and school has been going really well for the first time. He can focus really well when he is interested/challenged and properly accommodated for writing tasks, otherwise not so much. We've also spent a lot of time talking about how to deal with the frustration he feels with dealing with the LD challenge.

DD7 has a 2 SD gap and no one has ever suggested ADHD for her. We mostly tested because of her brother's scores and TBH I'm still kind of surprised at how similar the results were because in real life they are very different kids. She's breezed through school so far although this year we're starting to see cracks in her tolerance of "boring" worksheets.

My DS and DD also have similar presentation in SD differences, and in fact, slightly lower PSI. I've been told it's fairly common among gifted kids, and nobody has flagged ADHD for either.

DS has some visual processing issues, but both of them are on the careful and meticulous side, and think things through. He has no attention issues at all that I can tell. DD maybe has some executive functioning challenges, isn't a great speller, and she kind of daydreams.

Our reports didn't suggest ADHD but did suggest things like possibly allowing more time, avoiding timed math tests like minute math, or allowing them to do more difficult questions rather than all of the questions -- advice our school doesn't seem to follow, but hasn't really even been an issue, but if it is for your DD, perhaps it's worth mentioning? I've explained to my kids that fast in math doesn't equate to good at math, and they are cool with that and both feel good at math despite not being the fastest in class at timed math, because they are really good at reasoning and getting their actual work done easily.

I have a different perspective on this, because my child is older - 12 and in middle school. What I thought was intolerance to boredom and lack of patience for certain tasks in the elementary school was in fact some struggle with focus and sustained attention. I remember thinking that her mind restlessness/daydreaming was a good thing and more or less an indication of creativity potential and ability to think out of the box, but I no longer think like that.

Elementary school being easy/boring was actually a very bad thing because it didn't teach her responsibility, study skills and work ethics level, which are critical in the later years of schooling. She flew through minute math or book reports or "science", never needing to practice before the test day or anything else.
On the parent's side, the school being easy didn't flag the need for more organizational/structural support at home.

PSI+WMI equates to what psychologists call executive function or EF. What they say is that typically, unless the child is very obviously affected, the EF doesn't play a big role in child's life until much later, but once it does it may have a bigger impact on child's life than the first cognitive scores combined (GAI) and I tend to agree with that. My daughter currently scores at the level of PSI+WMI on standardized tests instead of VCI+VSI+FRI as she should. PSI+WMI being low seems to be common in high FSIQ individuals, and it is hypothesized that it may account for a significant rate of high school dropouts among high IQ individuals (up to 20%, which is higher than for kids with above average IQ).

That's why I am here. I am absolutely sure it isn't too late and I am looking for solutions. I don't like the idea of medicating my child, and the current research shows little effect from stimulants on the academic performance, but it does seem to address the executive function in the child to some degree and I am 100% sure that lower PSI+WMI scores and somewhat lower academic achievement are completely related to that at the older age.

I want to start small and see if simple changes in routine, diet may help, but don't know where to go with and there is so much "noise" on Google as to what actually helps, specifically in case of gifted children. I've read that 100mg of caffeine has the same action as low-dose stimulants and is safe in older children (she is physically a young adult). 100mg is an equivalent of a cup of coffee. The research is iffy on this subject for ADHD patients but seems to support the idea of memory, focus and attention increase in otherwise healthy people. What do you think? Is that crazy or us, adults, clearly benefit from it, so why can't an-almost-adult do it too? Would CBT therapy be useful (cognitive behavior therapy)? Any recommendations on how to boost organizational aspect of her life?

One last point... I agree that to be diagnosed with ADHD one's attention levels have to be below typical, as in below 85 or at least 100 on PSI and WMI on WISC. She is 115/108. So it isn't a true ADHD, but it is an issue regardless, because it inhibits her ability to reach her true cognitive potential.