Okay I've been trying to piece together different puzzle pieces for about 10 years for my son and we've gotten various alternative and conventional therapies for different things over the years. He is 11 now and a lot of his "issues" have improved, but he still has some lingering:

1. Auditory: Just did auditory processing disorder testing done and is in normal range (no APD dx) for everything hearing wise and greatly accelerated in language portion. BUT often has to make the speaker (outside of family) repeat what they are saying. Everything else listening seems fine, just that one thing and I think once he is further into a conversation it gets better. The initial hearing is always a fail though.

2. Vestibular: Has a "mild" Vestibular Dysfunction dx ... spinning is intolerable and gets motion sickness in cars. But the OT doesn't see a need to continue therapy.

3. Emotional regulation : This has gotten a lot better over the years. Now the only time it really erupts is in soccer games (when things are not going well or so perceived). Always on way to games he thinks he will be fine but in midst or toward end/after game he falls apart. My theory is the increased adrenaline makes it extra hard to self regulate and think clearly of strategies.

4. Fidgeting/Tics. Since age 5 tics but never severe. In past year has incorporated "drumming" and knuckle cracking by making fists. I never have discovered the reason for the tics but have had an underlying suspicion that his nervous system is just too overactive. Anxiety runs in one side of the family but I wouldn't say he really is generally anxious. But can't lay still like for a yoga savanna with eyes closed if his life depended on it.

5. Weird belly button sensitivity!! Apparently even talking about the belly button makes him extremely frustrated and uncomfortable. It isn't debilitating per se but it is a big source of aggravation that he tries to ignore. Past year or two, just found out. Caused by anything touching BB (or the thought of it).

6. He has been tested various times over the years and is in gifted or highly gifted range and is in SSA for math but he is LAZY. This is not an issue of he is not being challenged etc. He abhors the idea of "effort" and "work" and "homework" and "studying" ... is this a symptom of something??? Sometimes I think it is related to the auditory and emotional regulation problems ... just not putting the effort in to listen enough or control the emotions. Ex: If a reward is given he will not cry during a soccer game! He gets good grades but it seems like he is putting forth very little effort for them and acting like he is working so hard (like a tiny worksheet for homework is arduous, and it really isn't even time consuming it is just "effort").

I know this is all over the place, but we've tried so many things and I am just wondering where to go next. Brain Balance??? Very hesitant. OT again?? Just ignore it all and hope for the best?

Just had to lol at the belly button thing. I am so grossed out by my belly button being touched and I remember that book "The Belly Button Book" from when DS was little and it made me feel queasy just to read. I also have tons of trouble with motion sickness, I always have to drive and forget sitting backwards on the train! I don't know about most of this stuff, but number 6 is how I felt in school (and still do with paperwork or filling out forms) and I have mild ADHD. Concentrating on something boring makes me feel physically sick. And almost all of school was boring for me, so I was a poor student. When I got to college and was able to choose what I was interested in and select only courses without homework requirements I did very well. I found a job where I get to be active and drive between locations throughout the day and it's perfect for me. If I had to balance a checkbook I'd probably be in tears by the end and yelling and throwing things, but I don't consider myself lazy in general just because it takes me so much effort. And I never balance a checkbook.

In our house, 1, 3 and 6 seem to be heavily associated with (inattentive) ADHD.

Thanks for the responses ... I will def look into ADHD. If there is anyone else who has input, would love to hear as well. Thank you

I just adding on a voice confirming sounds suspicious of ADHD. Especially #6, but calling it "lazy" is unfair and damaging to the whole family. I recommend the book "The Explosive Child" (poorly named, definitely worth reading!!!) and the corresponding website livesinthebalance.org

The sensory, ticcing, and attention issues together may suggest autism spectrum disorders, but one would need to know a lot more about social functioning.

There is no science behind Brain Balance. I'd suggest a real evaluation with a neuropsychologist, so you'd know what the issues are more concretely.

The belly button aversion reminds me of my son's aversion to gum chewing. If anyone even looks like they "might" be chewing gum he is grossed out. He can spot a gum chewer in a crowd of a dozen people in a few seconds. In his case I believe it's "misophonia" though which is a recognized phenomenon.

Does he have any hyperactivity? Focus issues? If so, look into ADHD? He also may have some executive functioning difficulties (the emotional dysregulation and lack of effort w/ work can tie into this).

I do not think you are going to find a nice pat syndrome name for that. I could write a similar list for my ten year old and have given up looking. Though they did tell us if we wanted it, we could have an ADHD diagnosis right away, but we refused, since he functions alright without medication and he wouldn't get accommodations in school anyway since he is doing so well academically.

It personally helps me to think of it from a functional perspective: stuff that looks like ADHD (or executive function delay, as I think it should be called, you may quote me in medical journals, thank you very much) I read up on how to help a kid with that specific EF problem. With stuff that looks more like ASD, I read up on that, same for stuff that looks more like SPD.

However, I do believe that now they are approaching adolescence, they will have to find the motivation themselves to work on their issues.

For instance, concerning vestibular issues, the OT told us he did not need any more OT when he was seven, but it took him till he was 9 to learn how to pump a swing and he only found the motivation because he realized his baby sister, four years younger, could do it!

With his screaming whenever he needs to touch wet fabric, I have to admit that I shouted back that touching wet laundry in order to hang it up or put it in the dryer is a life skill he needs to handle before he moves out, so he better start pulling himself together and practice. Well, guess that touches the emotional self regulation angle as well.

I guess when he makes his own money and still can't handle touching wet fabric, he can buy himself one of these washer dryer combinations that consumer portals always say keep breaking down. Until then, he better learn.

Two ideas for wet fabric....gloves or drop off laundry service.

I remember that my mother bought me a meatball shaper so I could help her cook without touching raw meat with my fingers. I outgrew it eventually. I bet your kid will outgrow the wet-fabric thing, too.

I sure hope so because I should like to teach my children household self sufficiency before they move out, and drop off laundry service sounds expensive!
OP, it just occurred to me that some people like the concept of Dabrowski's over excitabilities, because it is such a nice umbrella for basically everything that makes life hard for our kids and sometimes us, as well. I am personally a bit sceptical of the concept because it sort of descends into realms of moral superiority of intellectually superior people, but the over excitabilities part really resonates with many parents.

Thanks so much everyone. I keep forgetting to check back here for responses but I'm appreciative when I see new info. Tigerle, you have it right I think. I don't think his particular difficulties or "symptoms" fit neatly into a single category. It has always been that way. He has a little of this and a little of that. I haven't sought a diagnosis because he functions completely fine in school, gets great grades, plays competitive sport (although we struggle with the emotions of it) and has friends.

As his mom, I just think I see and receive the brunt of things and I wish him neurological calm and comfort . I hate that he is uncomfortable like with the BB thing and the ticcing when it is worse.

I had never considered ADHD ... and I could definitely read up on it. I just still am confused because he isn't "hyperactive"really. I guess it could just be a mild thing ... but he used to do origami for hours and rainbow loom ... very detailed things and could write sentences and form letters (small handwriting) from age 2-3 so I thought he could focus fine. It has just been in recent years that I have noticed his physical discomfort and low tolerance for things like writing/edits/revisions on writing. He can't stand edits or suggestions from me. But it is never like what I imagined ADHD to be with physical hyperactivity. Maybe it is just coming out now at an older age which I guess is possible.

ADHD comes in various subtypes: primarily inattentive, primarily hyperactive/impulsive, and combined. The symptoms also may not be that evident when engaged in high-interest activities (classically, video games, favored sports, etc.) Keep in mind also that the disorder is not really a deficit in attention (name of the syndrome notwithstanding), but a deficit in regulation of attention. So over focusing on one thing can be as much a symptom as flitting from one thing to another can be.

It sounds like he is engaged by creative work, but not by nitty gritty fine tuning work. And probably hasn't yet learned that there can be quite a bit of creativity in editing and revising as well.

Typically, ADHD is considered to be an intrinsic profile that exists from early childhood (formerly, before age 7, currently, before age 12), but environmental demands may not expose the profile until later.

Like aeh says, some kids with ADHD are not hyper, they are just unfocused or act spacey and have problems staying on task unless they are involved w/ something fascinating. My daughter could spend an hour deeply engrossed in a jigsaw puzzle, and she has been that way since she was a toddler, but if you ask her to write a paragraph, and it's a topic she doesn't want to write about, she gets off task every 30 seconds. I have to bribe her to do things like clean her room and break the task down into small parts. Otherwise it's hopeless.

Wow, this is enlightening. I really appreciate the information .. especially the subcategories, aeh. Looks like I have some research to do. And I will work on reframing his "laziness" to "inattention/inability to focus" ... I stand corrected. Super appreciate you all!!

I just thought of a big question though ... if he does indeed have something like the inattentive ADHD and homework/focusing on things he isn't interested in is kind of an actual challenge ...

1. I worry that telling him he may have this diagnosis will give him a reason to resist these things even more?
2. Since he is highly gifted, how does this effort (or inability to put forth effort) vs. academic aptitude thing work out through the middle school and teen years?
3. Do I need a diagnosis or can I just have him work with someone (or me) using strategies?

Sorry, I suspect this is super basic info but I am not sure what to expect or where to start. I did check out that livesinthebalance site and I will get that book The Explosive Child which actually I think I read years ago.

Thank you!!

As a parent of a gifted D17 who had really rough time in junior high, was finally diagnosed by a neruopsyc at 15 and who is now one month short of 18. A lot of these things will get better as he matures. Honestly.. Although I don't suggest you just ignore them all and wait. My son turned into a completely different child from between his freshman year in H.S. and his junior one. Some of this was because HE wanted to change & was motivated. I did find him a psychologist who has experience with gifted kids to work with him.

You have just hit the beginning of puberty. A lot of this being a kid who has just hit puberty.. maybe one that it not completely neurotypical (but every quirk doesn't need a label) but being 11 just ramps everything up to 11. And if you aren't the same way, it may seem like he's pushing your buttons. He isn't an adult. Many kids have a few ticks (my son used to chew on his shirts when he was nervous). Many adults get motion sick in cars if they aren't driving. Everyone in my family gets motion sick to some extent so I don't think of it being very odd.

As for the auditory thing. Have you consider that's he's very introverted and when out in public or in new situations he's on sensory overload. Perhaps he doesn't initially respond because you have to pull him out of his zone. This requires patience and understanding as well as training & practice.

My kid was tested and doesn't officially have ADHD and/or ASD. Although he does share some characteristics mostly he is a quirky introverted gifted kid. And honestly if you son my son today you wouldn't recognize the child he was at 11/12.

I wanted to add.. The blowing up thing. My son used to do this ALL THE TIME. It was a huge issue when he was 8-12. This is one of the area's where I think maturity makes a huge difference. He's in H.S. and now and I could never imagine him doing this. He's somehow learned to control this and I haven't seen him blow up like this in years. By H.S. this wasn't a problem at all.

It's tough being a gifted kid, particularly a introverted gifted one. Adults are constantly interrupting and want you to do anything but what's fun and interesting to you. Watch your kid and figure out when he's blowing up. I found the best solution to this problem was making sure he was in the loop and knew what the plans were for the day, gave him lots of notice as to when he needed to switch gears. Particularly very engrossing ones like computer games.

It became unacceptable in my house to throw a fit. But I also learned to read & understand what his frustrations were. We made plans I would give him warnings on when he needed to change activities. And yes... I don't need to do that now.

Good Luck.

If you suspect he might have inattentive ADHD and you want to try something like stimulant medication (or any type of medication) obviously you need a diagnosis. You can get a good idea of whether he fits the DSM criteria just by looking online. There are parent/teacher rating scales that basically confirm it. Although I recommend taking him to a neuropsych rather than relying on a paper-pencil inventory. If you don't plan to try medication then you could try interventions yourself based on books like "Smart but Scattered" but if you want the school to do interventions for a 504 plan or IEP you would need a diagnosis.

http://www.helpforadd.com/2013/june.htm

My daughter has an IEP for ADHD and I think she would be lost in middle school without that. I would be constantly emailing teachers trying to explain what her issue is and negotiating missing assignments, etc. With the IEP a case manager keeps track of her grades and assignments and deals with her issues. Some kids have 504 plans for ADHD which is just a list of modications/accommodations (like giving increased time to do work or modifying the assignments) but it seems to be really hard to get teachers to follow the plan.

Executive functions (the skills affected by ADHD) are the biggest predictor of academic and life "success". Without executive function, intelligence is largely irrelevant.

I recommend neuropsychology as part of diagnosis. I learned my son's "laziness" was actually an astoundingly slow processing speed. I have ADHD diagnosis myself and I learned my tested skills are not nearly so low as expected which indicated that environmental changes may offset my impairments - and they did. Neuropsychology may indicate the severity of symptoms, but cannot point the reason for the symptoms. ADHD is not the only cause of poor executive function and childhood sleep disorders are a common cause of "ADHD".

My nephew appeared to have ADHD. After neuropsych, now my sister knows he is neurotypical or gifted (she declined to be told IQ results) and his "symptoms" are counterwill. My niece in the same family presented with a severe academic delay - but she has ADHD most likely cause by high blood lead level.

I do not believe ADHD self-diagnosis can be done, there are too many differential diagnosis. ADHD is a diagnosis of elimination.

Diagnosis can be a lengthy or daunting process but I believe it's worth it. My DS9 is incompetent and cannot perform basic life skills without medication. Without medication he cannot function in any school setting regardless of the accomodations. Our home life was in turmoil and I was seriously considering putting him in foster care since he wasn't old enough for inpatient behavioral treatment. With medication, he is far beyond expectations for academics, hobbies, responsibility, and life skills. Putting him a first medication (which didn't work very well) corresponded with a 3-grade acceleration, and finding a best-fit medication corresponded with and additional 2-grade acceleration. When he was given school work at his intellectual level, his resistant school related behaviors disappeared and within a couple months his lingering behavior problems resolved. His anxiety and aggression/frustration disappeared.

This information is just so helpful, can't thank you all enough!

Surfbaby- I PM'd you.

The trick is to really get explicit about the difference between explanation and excuse. The explanation is incredibly important, because he (and you and his teachers) need to really, really appreciate that he is trying to do something terribly hard for him, for which he doesn't have the skills, and where he needs explicit, repetitive teaching of these skills, as well as supports to make up for their absence/ weakness (supports which can hopefully, slowly, be reduced over time - but are essential to start). All of you have to truly believe that he is not lazy, and no, he really couldn't if he just tried harder.

But that's no excuse. He's got to own that weakness. He needs to recognize what it is, how it affects him, and that it's his responsibility to do something about it. He needs to accept that he has to do things differently, ask for help, take longer, etc. It's not his fault that he is struggling. But it is his responsibility to do something about it.

With my DS, the avoiding work that's too hard because of LDs has fed a nasty cycle of avoiding effort when effort hurts. The hurt is legitimate, but the avoiding hard stuff is deadly. We're working very, very hard to undo this, and it would be a lot easier if we'd realized just what a vicious cycle this was, a whole lot sooner. Unfortunately, avoidance worked beautifully for him right up to middle school. For years, too many teachers let him get away with not getting stuff done because they knew the work was far too easy for him, while producing the output was very hard. argh. Now, the work finally isn't make-work. It's engaging, appropriate and challenging. And he has no ability to get it done. Yes, it does hurt. You have to do it anyways. It's your responsibility to work with the adults around you to find ways that work for you to enable you to get. the. work. DONE.

Highly gifted without work ethic is a recipe for trouble. Throw in unremediated LDs that the child has never learned to properly manage, and you have disaster.

You have enough questions that I would strongly recommend a full psych assessment if you can possibly manage it. You need to know where the challenges are in order to address them properly. Sooner is always way better than later. In the meantime though, Smart but Scattered (mentioned above) can help understand what some of the blocks are, and how they can be addressed. As a previous poster noted, good executive function is essential to, well, pretty much everything.

Thanks so much Platypus101 - I will def take all your advice!!!! Makes perfect sense.

Well said!

For item #5 in the OP, you may want to look up Omphalophobia.

Thank you platypus, that was such a helpful post.