I am uncomfortable with all these professionals blithely giving advice outside their specialties - the therapist and OT who are sure it's not ADHD, the neuropsych who spends most of her session giving parenting advice.
I would be skeptical as well.
I recall a (theoretically) qualified professional telling me that although DS had autism, if we parents would only apply time-outs correctly, he'd be fine. Uh, NO.
It truly feels like a mess.
Just because advice has been given, you are under no obligation to take it. I'd start by placing a veil of skepticism over anything that people said to you that is outside of their knowledge base.
And as geofizz said, look at the actual problems you're trying to solve, not at the causes people are hypothesizing all over the place.
I think our goal with the 504 is to codify this year's informal accommodations (FM system, preferential seating, reduced homework or scribing help, anything necessary for fine motor), in case next year's teacher is not such a good fit.
That's a very good plan: get what works onto paper and formalized.
If he needs OT for the fine motor in school, that's probably going to be in an IEP, not a 504.
(And, it turned out the CBT therapist, in the same office, had been encouraging him to leap around on the furniture to "work out his energy." Completely unacceptable, he knows, but he had been encouraged to do it there.)
That's very odd. My feeling is that you're making a good call by ending the relationship with this particular CBT; I would also say that not all of them are like that.
The sudden, disproportionate outbursts of anger and opposition (yelling, sarcasm, slamming doors and throwing stuffed animals) are troubling, but seem to be decreasing. We're working through the Nurtured Heart program. My gut is to end the CBT sessions which are clearly exacerbating bad behavior, continue to talk about how we all have big feelings in this family and we can all work on managing them, and hold off to see if other improvements mitigate this.
If it stays on the radar as a consistent problem I would definitely look into ABA therapy.
My gut says there's some kind of fine-motor issue. I'm less sure about a vision issue. His ophthamologist pronounced him perfect in August, FWIW, and did an extra convergence exam at my request since I had convergence issues as a child. My one concern - he reads easily several years above grade level yet absolutely refuses to read books that are straight text, as opposed to Captain Underpants-level books with illustrations on most pages. He has no trouble with small type or concentrated text (something like the Marvel Encyclopedia) as long as there's an illustration on the page.
Our DS11 (2e/Asperger's) has both the meltdown/rigidity issue and the strong preference for comics. For a while he read the captions of books instead of the texts, and inferred from those what the texts were about. He can now process text just fine. (FWIW, the Tashi books were a useful pivot for us into more wordy books, as were comics with more text in them per frame, like Asterix.)
I think you are reasonable to look at control issues. At 7 the preference for illustrated stories is not yet worrying, but in a gifted child who clearly can read text, one wonders about it more.
Our big global issue is rigidity and I do think it's becoming limiting. Very picky about food - eats a decent variety including many vegetables, but very specific brands/preparations of each. Will detect a different brand of organic cheese stick (unwrapped) or macaroni that is "too straight," and will excuse himself politely from the table and go hungry rather than eat it.
Our DS was like this. We worked on it through ABA, and now he generally eats what we eat, though he still gets anxious about unfamiliar dishes in a new restaurant, etc. I'm sure I've posted about this here somewhere. It wasn't pretty but for us it was a problem worth solving.
How we have dealt with rigidity is tough on everyone in the short term but really works in the long term: you make choices that challenge his narrow limits. (A friend calls this "deliberate sabotage.") You run out of the favorite brand of cheese stick and he has to settle for an alternative. You drive an alternate route. Eventually a rigid but bright child notices that the new way did not kill him, and that he's still okay.
Very reluctant to go outside his comfort zone - had a tough time getting him out the door yesterday though we were going out to buy a swingset. Very tough time with transitions. Resists even the most tempting new activity (afterschool robotics class with his two best friends) and then is upset when they have fun without him. As far as DH and I can tell this seems to be about control. None of the assessments seem to have useful insights on this front.
Did they do an ADOS (test for autism spectrum disorders)? Some of what you've written falls along these lines, and ADHD and autism can sometimes easily be mistaken for one another in the high-IQ range. I'm not suggesting that this would be a slam-dunk definite diagnosis at all, but suggesting that it's worth looking at to rule in or out. I would use someone who's seen lots and lots of bright anxious kids both on and off the spectrum, which probably means doing the test at an autism center.
DeeDee
