Gifted Issues Discussion homepage Forums Twice Exceptional concentration in inattentive ADD?

Hi,

I am wondering what inattentive ADD would look like in a otherwise gifted preschool boy? Seems like non-hyper ADD is mostly seen in girls and is usually diagnosed in elementary or later school years as a result of unexepectedly poor school performance. What would it look like in a preschooler?

I've had a few experiences with DS lately where I thought, "Phew, he's acting so normal, maybe he's normal after all". But in retrospect one time was a day of airplane connections measured in minutes, and the other time that stands out was on his first trip to the ER. Those two days he seemed to me slightly eccentric but fully functional, whereas the rest of the time I question the latter part. So I'm thinking that if he's mainly normal at times when other people are stressed out then maybe I should think about ADD, which runs in the family except as ADHD. Since DS can concentrate for long periods of time such as listening to audio CDs, drawing things for hours, I had kind of assumed it wasn't an issue. But he isn't much asked to do things he didn't choose, and when he is he doesn't do them even though he thinks he will. Perhaps that is just the age and parenting style though.

Anyone have a ADD boy who they noticed as a preschooler and what did you notice?

Polly

Polly ADHD was explained to me as not the inability to pay attention, but the inability to CHOOSE to pay attention to something necessary but boring. Sure he may be able to read or play computer games for hours, but he may be literally unable to make him self focus on hand writing, or keep focused on getting dressed when he can see the Lego, for example. The question is how age appropriate is his level of distraction. Particularly if he is noticing more input than the average child of his age.

ADHD-I is common enough in gifted and highly gifted boys. They also say that medication is 'less helpful' in ADHD-I but with mine and many others it's been very very helpful. Like the common knowledge that being able to focus rules it out - NOT.

It's possible that ADHD-I in gifted kids is a totally different disease, and that 20 years from now it will be recognized as such. There is a subtype called 'Slow cognitive tempo' worth looking into.

Also check if your child is actually having mini-seizures!

My observation is all about doing things that there is no internal drive to do and self control. OverExcitabilities may be a huge part of these children's lives, and their reaction to the OverExcitabilities maybe more intense than expected.

I don't think it's caused by parenting, but 'super-parenting' can go a long way in these situations. My favorite book is 'Transforming the difficult Child Workbook' by Lisa Bravo.

Also -Preschool is a great age for OT treatment of Sensory Integration Disorder if OEs are an issue.

It isn't going to be easy to find a professional who will be subtle enough to diagnose ADHD-I in a preschooler. Read up on 'MisDiagnosis and Duel Diagnosis' by James Webb (Any of those authors would be good choices for testing when the time comes.)

'Different Minds' by Dee Lovecky is a very dense book jammed with info about gifted kids with ADHD and AS. When you've read that you know you've read it all.

If your (like me) have a parenting perspective where you child is mostly getting settings and activities that they like, it may be hard to notice Intense behavior. Remember that children 'shape' parental behavior as much as parents shape children's behavior. Some of us gifted moms are very sensitive, good at problem solving, imaginative, and open to being shaped behaviorally. We run into the situation of children who are well enough behaved as long as Mamma is running the show, but stressed or acting out in other situations. It's easy for us to take a political view and say, "Well, who came up with the idea of having child........, anyway?" or "He's just bored, this stuff is totally wrong for kids."

You seem ahead of me in that you know your child is gifted, and you know that your family is ADHD-o-genic. I was still taking that 'Political' perspective during my son's preschool years - plus I was working 20 to 30 hours a week outside the home and that seemed to be enough different from my own upbringing that 'all bets were off.'

Genes are the largest cause of ADHD. If you look around at your ADHD-hyperactive relatives, you will notice that many of then resemble ADHD-I as they grow up, yes?

Great topic - Thanks for bringing it up!
Grinity

When my children, both inattentive, were pre-schoolers I thought that they had amazing attention spans. They would sit for hours with play-dough, drawing, in the sandbox, playing with barbies, trucks etc.

By 1st grade, teachers were concerned with my son's ability to attend. I could not believe it! After exhausting every other possible cause and remedy for ADHD-in, he trialed stimulant medications at age 8. The results were positive, immediate and dramatic.

Looking back, I think my kids' ability to sit for long periods of time was a result of their inattention. They would play a bit, look up, let their minds wander, go back and so on. (this is what homework looks like!).

I am not saying that being able to sit for a long time indicates inattention - just that for kids with ADHD-inattentive, the red flags can be confusing.

And, as Grinity mentions - there is a genetic component. As I look around both sides of the family, I see many relatives that are most likely undiagnosed with ADHD. Now that my kids are older, the symptoms are a bit more clear - difficulty sustaining focus on a single task (and focus and distraction is easier to see), forgetfulness, lack of planning.

Mich, what did you do for the ADHD-in besides the meds? Were there behavioral strategies that actually got you somewhere?

DeeDee

My son has learned systems, strategies, processes for completing academic work. His school explicitly teaches the strategies and is very structured. He does well with this - once he has a system, he is happy to use it. For both my children, I encourage exercise and movement breaks to help keep them alert and engaged, and I remove all distractions like facebook and cellphones. The later being more of a problem for my HS daughter. Both kids do better if the work is broken into chunks - with breaks in between work sessions. Both require extra time to complete work and benefit from clear expectations and mental or physical images of the end product. I try to keep instructions brief and get confirmation that they understand and have fully heard me - my daughter is especially good at "selective hearing" ! Everything has a place - and although neither kid is consistent with this idea, I hope it will take root some day. Otherwise, they lose and forget things on a daily or hourly basis. My daughter does not take medication - the exercise and structure seems to be enough for her.

I have an ADD gifted boy, now 11 years old. I knew something was "different" about him as a preschooler but didn't know what (he was only officially diagnosed this year).

He had great concentration as a pre-schooler for things he enjoyed like reading, drawing, going to theatre, listening to music, etc.

I had several teachers in the early years (3-6 years old in Montessori) mention behavioural issues that I now know are ADD hallmarks (not wanting to do work that didn't interest him, not answering/hearing when spoken to, sensory issues like walking in circles, trouble with modulating his level of arousal, trouble with transitions, social difficulties, trouble following instructions, losing things) and at the same time say, "but he doesn't have ADD because he can concentrate so well!"

I had a psychologist tell me that at first she thought DD had classic ADHD-I, but then DD was able to concentrate when there was some visual input so she's fine. Still cranky about that advice from someone who should have known better.

This is really interesting stuff to hear.

It sounds like there are professionals out there who don't really know where the line is between normal and ADD. Are there any ADD type tests that are valid at 4? Or what would one look for in a professional to find one that could pick this apart at this age?

Polly

We have not found anyone willing to diagnose before age 5, and even then, it's more like "see how he does in school, and if there are enough problems of the right kind we'll diagnose" than like having a really clear set of criteria. So far as I can see (limited experience as yet) that's pretty much the way the DSM is written, not the fault of the professionals alone.

DeeDee