Gifted Issues Discussion homepage Forums Twice Exceptional Twice Exceptional Test Results

Hi!

I've been lurking for the past few months and think it is time that I officially join your group.

DS9 was diagnosed with Sensory Integration Disorder (tactile, proprioceptive and vestibular issues) last Fall and has been in PT/OT all year. He has had a lot of issues at school (not paying attention, illegible handwriting, inability to do written out math), but I he has always been considered a smart kid. Anyway, our PT suggested a full psycho-educational assessment...which is why we are here. We have come away from the assessment with a diagnosis of ADHD inattentive type and the following test scores:

WISC-IV
VCI 132
PRI 135
WMI 113
PSI 112
FSIQ 132
GAI 140 (if I calculated this correctly, the psych did not put in her report)

WIAT-II
Reading 120
Mathematics 123
Written Language 113
Oral Language 126

For anyone interested in his WISC Subscores used for GAI calc:
Similarities 16
Vocabulary 13
Comprehension 17

Block Design 18
Picture Concepts 12
Matrix Reasoning 17

The psychologist thinks that if we can properly medicate him for the ADHD, then his achievement will fall more in line with his IQ.

I'm looking for any kind of advice/experience that any of you have to offer.

Thanks!

This seems to be likely. Your son's scores are definitly gifted, but his working memory and processing speed put him at about the 65th percentile for his agemates - strong compared to average kids, but weak enough that they may be frustrating to him. If the ADD is causing those weaknesses, then yes, medication might free him up from those weaknesses and allow him to use his strengths without so much hassle. Or maybe your son is missing enough of the classroom instruction due to the ADD, then it seems likely that with the medication that your son's efforts to stay on task and benifit from the instruction would increase and his learning would increase.

The other things to consider is that ADD often has other 'co-morbid' problems with it - so if things don't 'spark up' right away, keep checking for Learning Disabilities, Anxiety, Depression - the usual suspects.

Also, even with medication, your son will likely need 'direct instruction' probably from you, in organizational skills, the search term is 'Executive Function.' Biofeedback and Meditation are helpful for some gifted+ADD folks.

A great book to have on hand:
Misdiagnosis and Dual Diagnoses of Gifted Children and Adults: ADHD, Bipolar, Ocd, Asperger's, Depression, and Other Disorders [Hardcover]
James T. Webb
Edward R. Amend (Author), Nadia E. Webb (Author), Edward R. Amend (Author), Nadia E. Webb (Author), Jean Goerss (Author), Paul Beljan (Author), F. Richard Olenchak (Author)

Best Wishes,
Grinity

Wouldn't WMI and PSI of 112-113 be more like 80th percentile? This doesn't sound like much of a "roadblock" to me, but maybe others have more insight?

Does he like school? I imagine that the combination of ADHD and really smart can make school seem boring (intellectually) and difficult (having to stay on task and listen) at the same time. That's how my DS11 sees school (doesn't have an ADHD dx yet, but might have one soon).

Has your DS started medication?

Verona, I'm not sure what you mean by "roadblock", but the WMI and PSI are significantly lower than his VCI and PRI (which is quite common in ADHD), in which case the FSIQ is not thought to be an accurate measure of actual IQ and the GAI is recommended to be used. Learning disabilites are defined by WIAT scores that are more than 15 points below the FSIQ or GAI.

He likes school, but has become very lazy. He knows the material without studying and does not care if he gets an occasional bad grade due to lack of effort. One of the reasons I had the testing done was to see if he was simply unchallenged or truly had attention issues. It is probably a little bit of both. We meet with a psych next week to discuss whether or not to medicate.

Thanks! I googled a chart, and got low 80s for a % this time - srry.

But yeah - it's low enough to be a bottleneck for some gifted kids. Depends on what is driving the numbers - if the child is extraordinarily careful during testing but not so much in a classroom, then I wouldn't expect it to be a bottleneck. If the child is 'slow as molasses in January,' and always has been - well, yeah.

Smiles,
G

Sounds a lot like my DD at that age. I assumed the grades were dropping due to laziness and boredom for way too long. Oh, if I could go back in time with what I know now, I would take back every thought I ever thunk in regards to my DD being "lazy".



The way I understand it is that even if the WM and PS are average or even above average, if they are > 15 points lower than the VCI or PRI for that child, they are insufficient to run that child's program efficiently. Sort of like the software is just too advanced for the available RAM and processor...

Thanks Nik, That makes a lot of sense. What happened with your DD to turn things around?

And for Grinity- I just ordered the Transforming the Difficult Child workbook. Does your DS also take meds or do you just use this approach to deal with his ADD?

What happened was I found this forum! lol. Short story is that I had her tested: VCI 141, PO 119, WM 102 and PS 105. She was diagnosed as ADD inattentive and she is now on ADD meds which she said made a big difference from day one.

Long story: My DD was already reading at a college level in 3rd grade and she just absorbed math, music, languages and science on her own at home so I kinda saw school as little more than free babysitting and a chance for social interaction. I briefly tried rewards and punishments for grades to appease her teachers but that had no effect, she made 100's on tests and zeros on assignments across the board for years. I sympathized with her not wanting to waste time on homework since she already knew all of the material so I let it go...I figured eventually she would want something badly enough to pull up her socks and work for it but then that day came at 17 and it became apparent that she couldn't pull up her socks. We had visited her dream college, she fell in love with it and verbalized very articulately to everyone who would listen all of the reasons she wanted to go there, but when it came time to write them down for the admissions essay she just literally couldn't do it. She did finally sit down and knock out a great essay at 4 am on the last possible day but it took 3 months of mentally working on it.

Now that she is on the meds, she is writing up a storm, all the essays, songs, poetry etc that have been churning around upstairs are now flowing freely onto the paper, it's nothing short of a miracle. And I was probably the most anti-med person on earth before this.

Your DS's scores aren't as far apart as my DD's so he may have different issues but at least you are on top of it early enough to stave off the road to depression that my DD went down. (She's happy now and all is right with the world at last . I wish it hadn't taken so long for me to wake up!

Sorry, I think I wrote that post too quickly! I really just meant that although his WMI and PSI are "relative weaknesses" for him, in the absolute sense his results are still higher than more than 80% of children his age. I didn't mean to imply that "relative weaknesses" couldn't cause difficulties and frustrations at school.

My DS has an even bigger spread (similar to Nik's DD). We recently had a full neuropsych. assessment done (WISC redone, WIAT, executive function, memory, attention) and will have more information to go forward with soon.

Hi Verona (wave), I hope you come back and post your diagnosis, I am curious to see what they say, given the similarities between our kiddos scores.

Hi Nik (waving back!)
Yes, I will post an update. Our follow up appointment is the week of May 30. Seems like we have been waiting forever.

What did they base the diagnosis on? I don't really see it in the numbers you posted. Is it classroom performance?

LinCO-

She based the diagnosis of ADHD on several things....first was the BASC screening forms that his teacher, my husband and I filled out. Second, she administered a computerized test (can't remember the name right now) that tests for inability to control impulse. Third, she was able to observe his behavior during the testing and interviews. I feel very confident that the diagnosis is correct. It shows not only in his classroom performance, but also his ability to follow through on instructions at home or to pay attention while playing extracurricular sports like baseball or soccer.

She diagnosed him with a disorder of written expression based ont the fact that his WIAT score in writing was more than 15 points below his FSIQ and by having him do writing samples during his testing. He writes some big letters, some little, has lots of reversals, does not use punctuation, has tons of mispellings (although he aces every spelling test and won his class spelling bee).

Does this help answer the question? I'd love any advice or input!

So perplexed, are you still at the point of teasing out whether medication or other treatment for ADHD is warranted? Are you considering extra time, use of a laptop or other accommodations? Or, are you thinking that some sort of remedial instruction is needed for the writing and other areas that are relative weaknesses?

I don't see him as a student requiring remedial help - even with the discrepancy, I think you'd be hard pressed to get a district to agree that he has a LD that needs treatment under an IEP plan. Unfortunately, the special ed laws don't provide that a student reach potential, only that they make appropriate progress. Typically, appropriate progress is a low floor.

But, if the writing and ADHD are interfering from him accessing the curriculum (and this would be determined via the evaluation, a look at his classroom performance and other data points) - even honors and AP courses, a 504 would be warranted to give him the accommodations he needs to succeed.

Also - keep in mind that ADHD is a medical diagnosis. If the evaluator is not a MD, she will most likely make a referral of some kind to a medical doctor. Often a Developmental pediatrician, neurologist or psychiatrist.

Relevant regulations regarding identification of SLD under IDEA 2004:
IDEA - Building the legacy

mich- We meet with a child psychiatrist next week to confirm the diagnosis and discuss whether or not to medicate. Luckily, I live in smallish community (ie I know the administration personally and they know my children outside of school) and we have good resources (International Baccalaureate starting in 1st grade), laptops are a requirement for all students starting in 5th grade and optional for 4th graders, availability of voice recognition programs through school, etc. ......so, I am getting great cooperation in putting together a 504 for next year. The principal says that we can get an IEP in place once we sort through his needs before he changes schools for middle school in 6th grade.

I guess, what I'm looking for is any of you who have "been there, done that" with the ADHD or writing problems and have any advice on what did or did not work for you. I believe that information is power, so I'm looking for as much info as I can.

Thanks!

Glad to hear that your school is so progressive - you are fortunate! AND glad to hear that you are working with a psychiatrist - the MD issue is covered.

For my "typical" daughter with concentration, working memory and processing speed issues, a 504 plan that includes extra time, graphic organizers, models of expectations and laptop have made a huge difference. She is still not a literary genius, but she is more confident and able to produce better written work with the above. We chose not to put her on an IEP because we felt that in HS, the peer grouping for remedial help would not be appropriate. Instead, we opted for the 504 and hired a tutor.

My gifted son with severe reading and writing disabilities, also has access to a laptop. His IEP provides for intensive remediation. His school uses the EmPower program http://www.architectsforlearning.com/empower.html and explicit models and techniques for producing written work. Based on what you have posted about your son, I don't think this would be necessary. I would assume he has mastered proper writing conventions/mechanics etc - otherwise he would not have scored as high as he did.

My sense is that maybe his executive functioning issues from ADHD are the roadblock - not poor writing ability/skills. Given sufficient time and a process to plan and check his work, I bet he will be ok.

perplexed I sent you a PM.

mich- I'm glad to hear that the 504 plan has worked well for your daughter. Your 504 plan sounds similar to what we will be requesting. I feel kind of silly asking for more time though, because right now DS hurries as quickly through his work as he possibly can. I know if he took more time to concentrate, his writing would be better. Maybe ADHD medication will help with this?

My DS sounds like he is somewhere in between your DD and DS. His reading/writing deficiencies are not enough to put him in remediation, but he does have significant fine motor issues. Actually, this whole journey started last summer when I had DS evaluated by an OT because he had not established a dominant hand and he could not button buttons, tie shoes or zip clothing. Turns out he had HUGE issues that he compensated for extremely well. He was diagnosed with Sensory Processing Disorder with tactile oversensitivity and vestibular and proprioceptive issues. We have spent the past year in physical and occupational therapy, but by the end of the year I realized that we had to be dealing with more than just Sensory Processing, so we had the psycho-eduacational eval done. Now I understand that giftedness, sensory processing issues and ADHD can often overlap. It is such a complicated issue!

Oh, and DS has not mastered proper writing conventions by any means. It is only recently that I'm able to make out the majority of what he writes, but it takes some deciphering. He still has a lot of letter reversals and forms a lot of his letters from the bottom up. He does not understand how to use punctuation at all. (he also doesn't pay any attention to punctuation when he reads.....he says he just doesn't "get it"). He does use grammar correctly most of the time. Everything is relative though and I can only compare his writing work to my 1st grade DS, who writes perfectly.

Thank you for the continued input! This is all incredibly helpful!

Perplexed, I am just so interested in these types of issues. I've seen a lot of info on these boards on nutritional and essential fatty acid interventions - I'm one of the believers. Love, love, love me a good OT also!

DS#2 is like yours you are posting on. The best support I've found for him has been allowing him to dictate his responses and writing - his oral language (both recep & expressive) are gifted, his written language about an 88. Handwriting, reversals, slow processing speed. He'll give these *great* oral responses ("Since the dawn of time blah blah blah whatever" and then when I tell him to write exactly what he just said, I'll come back to find "Oxygen is good.") Another strategy that has worked is to have him edit his own work for only ONE thing at a time - e.g. now check your spelling, now recheck for punctuation. Ugh, this is so time intensive for him.

For this summer's "home school," I've gotten him both the Language Mechanic and the Punctuation Puzzler workbooks from the Critical Thinking Company. They really look good-love, love, love their stuff. I am also going to have him work with a tutor on composition. I got a book of court cases from CTC, "You Decide" or something, and we are going to have him write decisions. He wants to be a judge. His problems with punctuation have really challenged ME - how can you not "get" apostrophes? Why would you have to cover their use more than just the introduction to them??

Also, my DS doesn't have the "H". I took him for a central auditory processing evaluation at 2nd grade (he's going into 7th) when his teachers said attention problems. He does have problems with background noise that have lead him to the habit of just tuning out. This is the basis of his 504. He still is a bit below where we'd like him in looking people in the face and speaking to them, e.g. coaches. Engage, son, engage!!

Lastly let me say with the mixed dominance, he's a really good batter. He's left eye, right hand and that gives him a split second advantage. Thank goodness he gets to USE the advantage, and not just the academic challenge. I really keep him in sports for the coordination etc. Also, and I think relatedly, they did find he is gifted in creativity. Now just how do you program for that?! They had no answers.

Linco-

I have to figure out how to search this forum and read about the nutritional interventions. I'm a big believer in "we are what we eat".

My DS is the same way...if I let him dictate to me, he will come up with the most amazing stories that go on for pages...but if he has to write it down, he will write the least amount possible....I totally relate to the "oxygen is good" example you used. I will definitely look into the workbooks you suggested, but I'm afraid it will be like pulling teeth to get him to do any schoolwork this summer. He LOVES to read, but otherwise does not like to do any kind of schoolwork or studying.

What do they do in a central auditory processing eval? I haven't heard of that one.

As for the mixed dominance....I wish we would stumble upon somewhere that it is an advantage. DS plays baseball and soccer, but unfortunately he is always one of the worst players on the team. Poor guy, just looks so awkward and uncoordinated out there on the field...but he is having fun and he hasn't reached the point where other kids make fun of him for being bad at sports, so we keep encouraging him to play as long as he enjoys it. I'm sure it is going to be good for him in the long run.