Hi Jen,

Your DS sounds rather a lot like mine in the pairing of anxiety/perfectionism with attention issues that lead to upsets at school. Ours has Asperger's, so YMMV for anything I say.

Your current treating professional--psychiatrist?-- what kind of testing information is she operating with in making her decisions? Some questionnaires, or something more rigorous? Is she a specialist in ADHD/gifted?

For our DS, to diagnose the Asperger's, they did a full neuropsych workup. This included unbelievably detailed developmental history, questionnaires for us and teachers, IQ testing, academic achievement testing (you asked about this--it measures what he knows), language testing by a speech therapist, the ADOS (autism rating scale), Conners' rating scale, the Vineland test of adaptive skills, and more. Close to two full days, with breaks. (We were lucky this was covered by insurance.) After which we came out with an incredibly detailed picture of strengths and weaknesses, including the giftedness and the social deficits and the rest.

I think if you're not sure what's going on with your DS in addition to the ADHD, this kind of testing is probably a smart idea-- if your tester is really sharp, they can tease out what the precise issues are, which can affect your decisions. Yes, ODD, ADHD, and AS can all look quite similar, or be comorbid, and some of the treatments are the same, but some of it's different, and you'd want to know what you're treating. I'd be very careful about choosing a tester, to find someone with LOTS of experience with 2E kids.

The achievement testing would let you and the school understand what work your DS can actually do, and the IQ testing might indicate his potential-- then you can start to make decisions about what's appropriate for him. Coming at a school with data is very different than just saying "but I know he's smart" when they are having a hard time seeing it themselves.

My DS hated homework, too, because he resented school so much in grades K-1. This has gradually improved with loads of positive reinforcement and treating the anxiety.

Nailing down the gifted numbers with IQ and achievement testing turned out to be important for us; getting DS placed correctly in school has helped him be happier, though it is not even remotely a cure-all. Anxiety is real, and it takes a lot to change those thought patterns.

I will say that for us the SSRI was extremely important. DS could not even access the therapies for improving his thinking around anxiety until we got him down from fight-or-flight mode with the meds. Once he was feeling calmer and more rational, the cognitive therapies "took" much better.

We also believe that DS was suffering tremendously. He sure wasn't wanting to have all those panic attacks, especially at school where it was embarrassing to be out of control, and it became imperative that we treat the anxiety by any means necessary. For us, anxiety interfered with learning.

We have found a developmental pediatrician who specializes in AS who gets the gifted piece and is reasonably conservative in her approach; she talks to us and DS for a long time before any change in meds, and has vastly improved our lives. YMMV.

DeeDee