Gifted Issues Discussion homepage Forums Twice Exceptional ADHD and behavior

Hi, I'm new here. We had DS6 evaluated for an iep recently. He was diagnosed with ADHD a few months ago and has been struggling to keep in together at school (1st grade). He is constantly in motion, fidgeting, talking, ect. He rushes through his work and then gets into trouble. He likes to monitor his classmates for misbehavior as well. Interestingly, in both K and 1st, his teachers had no concerns about his behavior for the first half of the year. This year's teacher even said, "he's easy" when I asked about behavior at the parent/teacher conference. It's the second half of the year that he seems to struggle to keep it all together.

He has definitely been more active, more argumentative and more intense, etc since he was about 1. I've suspected he'd be diagnosed with ADHD for awhile. He's also always been bright. He learns things very easily and has a great memory. I suspected he may be gifted, but I wasn't sure. He often insists on the most illogical arguments and... I don't know. I didn't want to be that mom. He didn't read or speak early. He feels more comfortable around younger kids and just doesn't come across as "gifted".

Anyway, we started medication for ADHD, but haven't found the right one. School behavior is still an issue. The teacher recommended getting a plan in place for future teachers, I requested the iep eval because I really wanted his iq tested as well.

So he had his iep evaluation done. They did the Wisc-v. Here are his scores

FSIQ: 143
VCI- 118
VSI- 141
FR- 140
WM- 130
PS- 129

The tester said that even though he has a large difference between VCI and everything else, it can't be considered a weakness because the score is still above average. A lot of scores I see seem to be the other way around... high VCI and lower elsewhere. But it makes sense for him, I guess. He's drawn to numbers, legos, shapes. But does not like writing or conversing. He prefers to be read to rather than to read.

The evaluation also said he shows characteristics of ODD, conduct disorder and signs of anxiety and depression.

The pediatrician wants to add another medication, but given that he's gifted and we've had lots of struggles with his behavior in the past, I feel like we should be looking into whether some of the behaviors are caused more by the OE being poorly managed by us for the past 6 years and what can we do to improve his mental state through means other than more medication.

So does anyone have any suggestions on where to start? He's in play therapy, but it doesn't seem to have benefited him yet. I was leaning toward a neuropsychological evaluation. From what I can tell that may possibly give us a good idea of what all we're dealing with. It was recommended that he have a sensory integration eval, so I plan to schedule one.

TIA for any input.

Similarities - 14
Vocabulary - 13
Block design - 18
Visual puzzles - 16
Matrix reasoning- 19
Figure weights - 15
Digit span- 17
Picture span - 14
Coding - 17
Symbol search - 13

Thank you for your response, Portia. The tester is the school psychologist. In her defense, she was very nice about talking to me and answering questions that I had. I asked for raw scores out of curiosity, but she said she couldn't give them to me.

And yes, my gut tells me he has some kind of anxiety issue that needs to be addressed. He scored very low on the anxiety evaluation I filled out, but I still feel that there is an issue. He noticeably avoids social interaction that is not on his terms. For example, if an adult asks him a question (even something simple, like, how are you?) He will either respond in a baby voice, make odd noises or just duck away. Other times, he'll engage in very over the top silly behavior.

And in general, I just feel that as parents, we've had too little patience for his high intensity. I worry that he has some emotional issues that may make the ODD symptoms worse.

Unfortunately, the two neuropsych places I've called are not accepting new patients. The scheduler I spoke to at the second made it sound like they wouldn't do anything more than what the school did in their evaluation. So, now I'm not sure if I should continue to look around or if I should just try to find a regular psychologist who has experience with 2e.


An additional question... the tester said that DS was all over the place while she was working with him. That he could barely sit down and stop moving, but during the times she gave him whatever material to work on, he'd settle right down and completely focus on the test. So I wanted to ask, knowing that his ADHD symptoms aren't well controlled, is it possible he could score higher when they are? The fact that he was fully focused while actually working with the material makes me think he probably did give a good effort and that the results are probably accurate. I'm just curious though.

You've received great advice above. I'll just add that reading these articles summarizing a recent Supreme Court ruling on educational benefit may be of interest... also this wrightslaw article on ADD/ADHD and special education. Here's more about ADD/ADHD presented by Understood.org.

Yes, he loves legos. We haven't bought him any really advanced sets. However, he did build the Millennium Falcon set in less than 24 hours (age range 9-14, which seems a bit older than it really should be) He will work for hours on legos.

Portia may not be a professional, but is still a very savvy and experienced parent!

I would agree that the relative weakness in VCI should not be discounted, just because it's in the High Average range. Your kiddo has a pretty marked difference between his exceptional strengths in visual spatial and abstract thinking areas, and personal weaknesses in language. This fits pretty easily with his experience in structured school settings. Think about a person of any age or ability who is able to think and process at a higher level than he is able to communicate, and how frustrating that feels. I suspect that he is quick, intuitive, and grasps concepts readily, but probably is not an exceptionally linear thinker (language tends to very sequential; his weakest nonverbal thinking score is in figure weights, which is closely related to algebraic thinking; he didn't do as well on picture span, which is strictly sequential memory, as he did on digit span, which draws on slightly more varied cognitive memory strategies). If you probe some of his "illogical thinking", you may find that he is using nonlinear, or simultaneous, processing to connect multiple disparate pieces of data into a novel conclusion much more rapidly than a linear thinker could make those connections. (Actually, an extremely linear thinker might never come up with those connections.) Because his personal weakness is language, he may have a hard time articulating the logic by which he identified those patterns. This does not mean there is no logic.

Now put such a learner in the highly sequential, language-rich, language-demanding setting of kindergarten and first grade. At the beginning of the school year, teachers expect that young children will be adjusting to class rules and expectations, and are more focused on enthusiasm. He is also young for grade, so most primary teachers will make allowances for "immaturity". After the winter holidays, their expectations ramp up considerably, as this is when they are looking seriously at students with an eye to retention decisions, either for academic or social-emotional-behavioral ("immaturity") reasons. They're "preparing them for second grade." NT students settle into the routine, and follow the rules, and generally have adapted by this point. Nonlinear, divergent thinkers, especially very bright ones, have a hard time fitting into the box, and getting into line. Plus, he's a visual spatial and conceptual learner, and the vast majority of kindergarten and first grade skills are verbal and rote in nature. The first couple of months, he might be able to tolerate the rote learning for the sake of the novel classroom environment. That gets old quickly, which leads to children creating their own interest in class--typically not something that the classroom teacher perceives as school-appropriate. He's probably significantly understimulated in school in visual spatial and higher-level problem-solving areas, and is seeking stimulation by monitoring other students, engaging in physical activity, and possibly even inducing little problems situations to be solved.

Given that he was evaluated for special education, was achievement testing done as well? Were there notable findings?

I also have concerns about an evaluation of a young child that throws around terms like ODD and conduct disorder, especially in the presence of a recent Dx of ADHD.

You may find resources such as Peg Dawson's book "Smart but Scattered" (www.smartbutscatteredkids.com) useful (resources for executive dysfunctions and ADHD). Also, Ross Greene's "The Explosive Child" (www.livesinthebalance.org).

I was waiting for aeh to weigh in before posting.

Regarding ODD, I suggest googling "counterwill".

I second aeh's book suggestions wholeheartedly!!

How have I never heard of counterwill before? That is my child. I will be diving into that research. Thank you

Aeh, thank you for your response. The way you described how it must be frustrating for him to not be able to communicate what he thinks strikes home. He really does stumble over his words at times and he just doesn't communicate well.

And your thoughts about how his school year progresses mirror my own, pretty much. We are having the first an iep meeting soon. I'm not sure what to expect, but I hope to address some of these issues.

I do have the achievement scores. They did the WIAT-III
Total reading-125
Basic reading-133
Early reading skills-121
Word reading-124
Psuedoword decoding -131
Reading comprehension-115

Written expression-126
Sentence composition-132
Spelling-121-she made a note that he relied heavily on memorization and that if he didn't know how to spell a word, he refused to sound it out. But she also said that when a word was written in the prompt, he preferred to try to spell it on his own.

Mathmatics- 135
Math problem solving-133
Numerical operations- 132

Oral language- 119
Listening comprehension- 109- she noted these last two scores are significantly lower than would be expected given his ability level of 143
Oral expression-123

When I spoke to her on the phone, she said that he is learning everything that he is expected to know and is even above average-superior. No learning disability was found. But he did qualify for an iep because of his activity level

The oral language achievement scores are not only significantly lower than predicted given his FSIQ, they are also in line with his VCI.

It appears that you may be in an RTI state, where the standard for learning disability is below grade level, rather than unexpected differences between ability and achievement (the discrepancy or pattern of strengths and weaknesses models). At his age, however, he can be qualified under developmental delay (for his self-regulatory weaknesses) in most states. With a diagnosis of ADHD, he can also be qualified as health impaired. Another area to bring up with the team, especially since she notes the discrepant weaknesses in oral language, is speech/language or communication impairment. Was he seen by a speech language pathologist for an evaluation? I'm pretty sure he would come out at or above average on most of those tests, given his existing testing, but an eval might still reveal relative weaknesses or clinical observations that might inform accommodations and interventions. Though I'll note that LC is also often compromised in learners with weaknesses in sustained attention. OE also has a component that can be significantly affected by sustained attention.

Also, his spelling behavior and lack of early reading advancement sound like he may have some vulnerabilities in phonics/phonological processing, despite his high ERS and PD scores. (Not much is expected from a first grader, so it wouldn't take much for him to score well, even if there are relative weaknesses in this area.)

You may wish to read up on how IEPs are written with measurable goals describing "what the school will do to meet your child's unique needs." You may later need to hold the school accountable for providing the necessary support to your child.
- roundup on Individual Education Plans(IEP) and 504
- Wrightslaw: Writing Smart IEPs

This ties in to the concept which others have mentioned upthread: "relative" weakness and "absolute" weakness. He may not have an "absolute" weakness as he is able to learn "what he is expected to know", however he may have a relative weakness as some of his scores are significantly lower than others.

For example, how is "what he is expected to know" defined? For this tester, it may be defined by common core standards for his age and grade level. However, it may be better defined as the achievement typical of children with his high IQ. Looking at it this way, we may begin to see gaps. The goals would be providing the support and remediation which allow him to learn to his potential. He may currently be compensating for deficits, and learning effective strategies now will help him continue to learn all he can in future years.

Thank you. Yes, I need to educate myself on this subject. I can already tell that I may have an uphill battle.

And I'm definitely going to address the weaker VCI score. He had an early intervention eval at 3 and there was a speech pathologist there.

If anyone is interested,

They did the CELF P-2. His core language SS was 112 (79th percentile)
For the GFTA-2 the SS was 86 (16th percentile)

They also did the BDI II and his cognitive SS was 123 (94th percentile)

I think my comments were being held for review since I'm new. They're now going through when I submit.

Thank you again. There is a neuropsychologist in the area that seems to have experience with the gifted. I'm going to give her office a call. I was trying the hospitals before.


I see my son's silly behavior as a way to avoid failure, which is probably very similar to avoiding rejection. I see this in DS in other areas too, to be honest. He will behave the same way if he is unsure he can do a task (in the past when I've tried to teach him to hold a pencil, ride a bike, swim, tie his shoes...) for the physical tasks, I've learned that I just can't push him. I can show him and then let him try it on his own when he is ready. He's now learned all this things but to swim.

So his EI eval definitely found language skills slightly below cognition (the gap has widened even further, since), and articulation markedly below both cognition and language. Articulation delays can affect phonics and phonological awareness significantly, as they break sound-symbol correspondence (the sound he produces when he says or reads a word does not match the spelling/phonemes, because he is not using standard articulation). Notably, you listed a number of motor coordination tasks that were late developing for him, which suggests that there may be some kind of motor planning or motor coordination, or automaticity factor in play, which would indicate that further evaluation by an occupational therapist (and possibly a physical therapist, if there are lingering gross motor delays) might be in order. I distinguish between novel motor activities and routine motor activities, as he is described as having strengths on several creative and novel perceptual-motor tasks (Block Design, Legos, etc.). Handwriting is another issue, as are bike-riding, swimming, tying shoelaces, learning to swing, holding a fork properly, dressing oneself, etc.

And, as an aside, I have every sympathy for the school evaluator, as that is my professional role as well. But the reality is, most training programs allot very little instructional time to GT, let alone 2e. I have benefited from many other sources of skill development.

Thank you so much for taking time to share your wealth of knowledge here. I really appreciate it. Everyone has been so helpful. I feel like I now have some idea where to go from here, which is so much better than feeling like there is something my son desperately needs but having no idea how to help him.

All of those routine motor tasks you listed have been a struggle at some point. I don't think he's terribly outside the norm, but he's always been so resistant to being taught or even encouraged to attempt these things. Since having DD2 (who seems pretty NT), I've really realized how 'different' my son can be. She doesn't know her alphabet, she mixes up the colors and counts out of order, but she likes to try to emulate grown ups, she responds (usually) to correction and she plays make-believe (which he never did. He played "race the cars across the floor" almost exclusively for years).