Gifted Issues Discussion homepage Forums Twice Exceptional ADD in girls

Hi, it's been a while since I've been here.....

DD6 has been doing great but we have noticed she is starting to space out more and more as school goes on. This happens at home when we are doing an activity and I believe it happens at school.
She is visual spacial as well as chatty, and at times (but not always) very energetic. She just seems a million miles away so often and I think it's starting to impact her school work and therefore her teachers perception of her and as such she is given less challenging work.

She tested above 99.9% across most categories (except working memory 65%)when she was 4. Her test graph looks like a winged v.

I'm wondering if it's worth getting her retested and perhaps looking at ADD or if this is just par for the course for gifted VS kids. I'd love some perspective before I go spending loads at the Ed psych and getting a normal diagnosis!

ADHD is a diagnosis of elimination. I think it's a win-win scenario to start investigating and ruling them out to the best of your ability before pursuing ADHD diagnosis.

I'd be wary if her procressing speed is high. A typical ADHD pattern is a large discrepancy between verbal comprehension index and processing speed. For example, my son's discrepancy at age 6 was huge. His IQ test at age 6 was FSIQ 106. His processing speed was 21st percentile. After ADHD diagnosis and with treatment, his FSIQ was..... 134? (I think?) and GAI was 141. Processing speed still lagged far behind, but was at 50th percentile.

I am extremely pro-ADHD-medication. But if your daughters only symptom is daydreamingness in the classroom and there's no big discrepancy with processing speed, I'll be more inclined to suggest there's a problem with academic match in her classroom.

One of the diagnostic criteria for ADHD is that symptoms are not limited to one environment, like school.

I'd encourage you to explore options to make her school experience better and carefully note suspicious symptoms. Work on sleep for her and teach her mindfulness meditation - which are both a very big deal for ADHDers. Be patient, if she has ADHD, symptoms will progress as demand increases in the coming years. When my son was 6, I didn't think he had ADHD (oops), but after a grade skip and after having him do schoolwork at home where I could watch, his symptoms became obvious. Your daughter might not fit diagnostic criteria today, but you might notice worsening progression and she might fit the diagnostic criteria next year. Does that make sense?

My DD still does what I call the 'Trips to outer space' at times but she is not ADD/ADHD according to her tester who is a very qualified and highly regarded NJ tester. DD also used to be more synesthesic around numbers than she currently is - I think she has learned to suppress it a bit - sometimes I wonder if it is a bit like children having imaginary friends that they grew out of...

I think that some kids get entranced by their own thoughts at times and this never goes away entirely. I myself find my thoughts can display almost a Brownian Motion trajectory through a train of thought at times. Listening/watching something especially interesting can open windows of insight and connections to related but sometime tangential areas that almost fractally spin off sub trains of thought. I wander more than wonder at times :-)

Does your DD6 find the school material appropriately paced and engaging?

I am always cautious about discussions of ADHD in 6 year olds, never mind highly-gifted ones. So many are struggling in environments that don't meet their needs, yet schools generally focus on fixing "bad behaviour", not a bad match with the child's environment. I would look hard at her classroom and schoolwork before assuming the child is the problem. Even without the added complication of giftedness, so many schools expect unreasonable amounts of sitting still and listening out of small children.

That said, I have 2 kids that do have inattentive ADHD (one mild, one extreme), and the signs were there when they were 6. When younger, though, it was more of a parenting challenging (getting them out the door or through a meal in less than an hour was always impossible). In school, attention didn't become a major issue until they were older, and LDs started to interfere with their schoolwork. When LDs make the work hard, sustaining attention on it becomes excruciatingly difficult. For my daughter, that happened young (grade 2-3), for my son, much later (in grade 6-7). Of course, too-easy work sets the inattention off big-time, too. Sometimes both at once (think math that is conceptually too easy to engage, but mechanically too hard to write out the lengthy show-your-work answers. Result - space cadet and a never-finished worksheet.) So the problem is not the LDs per se, but rather mismatched schoolwork more generally (whether too hard or too easy), rendering the work unengaging.

Keep in mind ADHD isn't an inability to pay attention, but rather an inability to *control* attention. ADHD makes it really hard to stay focused on things that aren't intrinsically motivating - which makes it look so very, very volitional. (Teacher: "I know she can pay attention when she tries - she does it fine with the stuff she likes! She just needs to try harder, and stop being lazy with the stuff that isn't as interesting to her.") With ADHD, the hardest thing in the world can be work that is too easy.

With respect to whether to test, it really depends on whether you see issues that are causing her real problems, now, or if it's just one teacher. If your daughter might be starting to see herself in any kind of negative way, or is acting stressed or resistant to any aspect of schoolwork (or other activities), don't wait. If you're worried that she is disappearing too much - or uncontrollably - into her own head, even when there's interesting stuff going on she wants to participate in, then that's worth investigating.

But if your daughter is happy, and it's just the teacher complaining that she's not paying enough attention to unengaging activities, well - focus on the environment, not the kid. Many gifted kids - especially those super-visual ones - have some pretty extraordinary stuff playing in their heads - rare is the classroom offering anything that can compete with its depth and richness. So while I tend to be a "more info is better" person, she's only six, and most testers won't do much at that age. If she's happy, and you can wait another year or two, you are likely to get more substantial info, especially if the issue isn't actually ADHD, or isn't only ADHD. However, if it's having negative effect on her now, don't wait. "Let's just wait and see if she grows out of it" is a terrible, destructive and pervasive educational myth.

Either way, every child can benefit from some explicit support and teaching of executive function skills. You can't hurt her by using resources like Smart but Scattered (Peg Dawson), acting as though ADHD were there, and helping build up her skills. You can do now what you would do if she actually were diagnosed - support and monitor - and if she needs more than that, then you can look at assessment and more intensive interventions.

The best diagnostic tool I think we have is - is she happy? Stress, resistance, or something that she can do but just feels way *harder* than it should for this child at this age - these are all big red flags that some barrier is in the way of the child doing what we are asking her to do. If you see any of those, investigating that barrier sooner is better than later.

ITA with Platypus re the above. I'd also add that it's really tough to know if the discrepancy between working memory and other subtest scores that was present at 4 is real or perhaps a sign that your then-4-year-old was tired during those subtests or wasn't engaged etc. Were there any notes from that testing that indicated whether or not the tester thought there was a contributing factor to the dip in scores?

The other thing to keep in mind - sometimes kids with LDs *look* like they are showing signs of ADHD. As mentioned above, ADHD is a diagnosis of exclusion - other factors that can contribute to the symptoms should be ruled out first. The dip in working memory (if it's real) could be due to other issues - which might, in turn, be what's behind the "spacing out".

All of which leads back to.. if you're seeing issues in school, if your child is frustrated etc... I'd check it out. If things are going well, I wouldn't worry about it at this point. As the parent of a 2e child who wasn't diagnosed until 3rd grade, however, I'd add that if you have any hints (from either your dd or your dd's teacher or your own gut feeling) that there's an issue, look into it. It's very easy to put off early signs of LDs etc to thinking a highly gifted child is bored or under challenged or disinterested or a perfectionist etc. All that might be true, and one of those reasons might be the only thing that's up, but testing doesn't hurt and it might reveal that there's something more going on. We missed the early signs in our ds, thought he was just an under-challenged perfectionist, and as a result of that also tended to put off concerns from his teacher. He was bored, he sometimes is a perfectionist, but he also had a very real challenge, and I would give anything to have found out earlier, as going through those first years of school undiagnosed ultimately took a huge toll on his self-esteem.

Best wishes,

polarbear