Originally Posted by Irena
Here is my gut, maybe irrational, emotional feeling: I think they WANT an ADHD dx and are pushing hard this year to get it.

We had a similar situation when our ds was in elementary school. In our situation, I don't think anyone specifically "wanted" an ADHD diagnosis, but it was what the school staff was most familiar with and some of ds' behaviors looked like ADHD (and it didn't help much that he had a preliminary ADHD diagnosis based on one teacher's opinion on a BASC when he was in 2nd grade). Whether or not the focus on inattention that's happening means that your ds' school staff "want" an ADHD diagnosis, I think it's important to listen to your gut feeling, and keep the focus on showing how the disabilities he's already diagnosed with impact him at school. If you find through the behavior observations that there are situations that aren't explained by the diagnosed disabilities then at that point in time you, as the parent, might want to look again at ADHD (or something else), but the first step is to understand how what you *know* to be his challenges impact him in the classroom and to get accommodations and remediation in place (not just in writing, but actually used) that address those issues. (I know you already know this, btw!). This also isn't a process that will be one-step - I suspect that you will have suggestions and ideas put in place from this first behavioral observation, and then his functioning in the classroom should be looked at again after the accommodations are in place for a certain period of time etc to assess what is/isn't working. If something isn't working, it doesn't mean he has ADHD, it means that thought needs to go into all the challenges he has, look at the specific situation and understand what's going on, and revise the accommodation etc.

Our ds' school team did like to suggest that anything that looked like an attention challenge was ADHD-related (particularly since he had that misdiagnosis in his paperwork). The way we had to deal with that thinking and with the suggestions at meetings etc was to politely and without budging remind the staff that ds had DCD, review what DCD is and how it impacts ds in general, and then explain to the staff how it was most likely impacting him in whatever situation was being discussed. If it showed up on IEP paperwork, we *always* used the comment column to explain that from our perspective how the issue was related to DCD (if we disagreed with anything the team said in official paperwork we always used the parent comment section to state our disagreement and our reasons for the disagreement). If it came up as an issue in a discussion in a meeting but wasn't specifically on paperwork, we followed up in a summary email from the meeting by stating the concern and then stating what we suspected was the reason for whatever the behavior was. In our case, the words "ADHD" weren't mentioned much once we were past the 2nd grade teacher and ds' IEP eligibility process, but the word "attention" was thrown all over the place all the time and the implication behind it was ADHD was the reason for inattention. It felt like I was saying the same thing over and over again sometime but it really did put a damper on the ADHD-push by saying things like "the reason ds may appear inattentive in this situation is that his DCD is causing him to (xyz)". Follow with details of how the DCD is impacting the situation.

I will also add that in elementary school ds was extremely disorganized, and much of that looked like ADHD (as well as tuning out when he was bored and tuning out when he was given writing assignments simply because he didn't know what to do). I feel strongly (and so did his neurospych) that the disorganization was related to his DCD. It was a larger "problem" for his teachers than his writing challenges or anything else, possibly because it was so easy to see and so easy to perceive as an attention issue. When he was first struggling in school with writing, and we were trying to figure out what was up, his teachers would often deny there was an issue but would immediately launch into talking about how disorganized he was, and organization goals were written into his IEP without us (parents) requesting it. He most absolutely was (and still is but to a much lesser extent) challenged by organization.

This is one example that comes to mind - I don't know if it would help in thinking through what is going on with your ds, but it helped me to have a specific picture of what was happening in the classroom at the time the issue was happening each day. My ds had huge challenges getting his homework turned in in 4/5th grade. I made sure that I knew each night what he needed to complete and hand in the next day, and I made sure he did it (this wasn't really an issue - he wanted to do his homework). I made sure it went into the top pocket in his backpack each morning and I made sure that backpack was on his back as he got out of the car and walked into school each day. I also reminded him as he got out of the car to turn in his homework. It made it into the "in" basket *maybe* 20% of the time. His teachers thought they had the situation set up in a rote way such that he should be able to get it turned in - there was a "homework in" basket on the counter next to the classroom door and kids were supposed to say hi to there teacher at the door, put their homework sheet in the basket, and then take off their coats at their cubbies which were inside the classroom. So the teacher saw a well-organized situation with a linear task1-task2-task3 expectation. What the teacher didn't see was that the lights in her classroom were kept on an extremely low setting so it was relatively dark in the area, the basket was semi-high up compared to my ds' height so it wasn't directly in his line of vision, kids had to line up and wait for the classroom door to open on many mornings and even when they didn't, there were almost always multiple kids trying to get into the classroom and tripping over each other as they went through the door - not a huge issue for a coordinated kid but for a kid with coordination challenges it meant a lot of focus and concentration was going into just staying upright and getting into the classroom in one piece. He was also thinking about how to go through the process of taking off his coat and hanging it up, because that wasn't automatic for him then, he had to consciously think it through. The lack of typical development of automaticity that comes with DCD also came into play here - a neurotypical kid would develop an automatic response to come through the door and put the homework in the basket early on but for ds with DCD it would - without all the other darkness and craziness and thinking about getting his coat off - still have taken him probably several months for that one action to become "automatic". It didn't help that homework was not given out daily or on a turn-in-on-same-day-each week schedule. Some days he had homework to turn in, other days there was none. It also didn't help at all that the teacher never specifically let either ds or parents know that the homework wasn't making it into the basket until weeks later.

The thing that ultimately worked for ds to get his homework turned in daily was being in a math class in 6th grade with a teacher who had a very regimented routine around homework - it was given every day, expected to be handed in the next day, the assignment was written on the board, all kids were reminded at the beginning of class that it needed to be turned in before class started, the teacher checked before class was over and any child who hadn't turned in their homework received a reminder slip of paper that parents had to sign and they had to bring the homework and paper in the next day. If it didn't show up the next day, the teacher called the parent. Being a year older may have helped too - as ds has gone through middle school it's become apparent to me that the combination of giving him very clear structure around things like this, repeat-repeat-repeat way beyond neurotypical expectations, and the self-awareness that comes with maturity all have played together in helping ds overcome many of his organizational challenges.

I also just have to put it out there - the math teacher with all the structured and repeated routine also had very bright lighting in her classroom smile DS has just this year started to realize light actually impacts his ability to stay on track and he specifically makes sure his area he's working in at home is bright and well-lit.

Anyway, I'm sorry about the rambling - I just offered that up as an example of how really understanding both the environment in the classroom and the specifics of a disability are important in assessing what is going on in the classroom.


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I think the teacher's talk in the lounge is that "[DS] doesn't need a scribe and writing accommodations - he needs ADHD drugs!

This might very well be the talk in the teacher's lounge, or it might not - but I think that it's not a bad thing to suspect that it is simply because it *might* be happening. Whether it is or isn't happening, the action you need to take to get appropriate accommodations in place is the same - understand what is happening in the classroom and think through how to solve it within the understanding of your ds' disability. The teachers and school staff aren't going to be the experts on EDS or DCD whether or not they believe that's behind the challenges or they suspect ADHD - you need to bring that expertise to them (which I know you're doing :)), and you'll need to keep at it. They won't just "get it" overnight, but you just have to keep plugging away at thinking through each situation in light of the disability, explaining the impact (again and again and again if necessary). Hopefully eventually the focus of the school staff will also turn a bit toward looking with the EDS and DCD in mind rather than automatically making the leap to attention and ADHD.

polarbear