Gifted Issues Discussion homepage Forums Twice Exceptional ADHD questions - long post

Hi all. I haven't posted in a while. Just wanted to give an update on DGS6.
He was given the WISC-III and scored MG with some really low scores on processing speed and working memory. We followed that up with a PIAT-R which showed him well above grade level in everything but reading comprehension, which is a grade below. I know it is not the best, but we are in a rural area and it was what I could get for now.

He is being evaluated for ADHD (almost certain he has it). So far, we have an anxiety diagnosis (we knew that) and a mild oculomotor issue for which he will begin vision therapy next month. The school is seeing some issues, especially the anxiety, but not everything we see.

We see the pediatrician tomorrow and she wants to have him evaluated by a developmental specialist and we have an appointment with a neurospsych later this month.

My biggest question is how do we get an accurate IQ test for him? We've spoken with the GDC, but are not sure we will get what we need there. Does medication help with the working memory issues and other academic issues? He is frustrated because he knows and understands so much more than he can express at school. Timed tests are a total disaster and his behavior is getting worse.

Sorry for the long post.

leahchris

If the vision therapy helps to correct his vision issue, that will impact specific parts of his IQ test results. He'll also most likely have an IQ test through the neuorpsych evaluation, and the neuropsych will be able to tell you which scores are impacted by the vision challenges (we have a dd with vision challenges which were helped through vision therapy, and that was our experience).

What are the symptoms that your ds has that your are almost certain are ADHD? Medication may help *if* the symptoms are ADHD, but if the only symptoms you've seen are working memory and processing speed, there could be other reasons your ds is struggling that aren't related to ADHD - so it's good that you're pursuing a neuropsych eval to sort through everything. There's probably no doubt that the difficulty and frustration over knowing and understanding much more than he can express is related to either his slow processing speed or working memory, but there are a number of potential causes for those issues - for example, my ds has the same challenges at school, and for him it is due to dysgraphia, developmental coordination disorder, and an expressive language disorder. If it were me, I would want to wait on any ADHD medication until I'd also consulted with the neuropsychologist.

I also wouldn't put much worry at this point in trying to go someplace like the GDC, particularly if it's a reach in terms of $ or travel. Testing through your local pediatric neuropsychologist first should give you quite a bit of information about his strengths and challenges.

Best wishes,

polarbear

Thanks.

Our pediatrician wants to hold off on meds at this point, too. Especially since his teacher is reluctant to do the scales, and she is a 30-year kindergarten teacher, and had been incredible with him this year. His challenges are almost certainly working memory, but the anxiety can cause deficits there as well. We have a strong family history of ADHD and on his mom's side there is autism, ADHD and Tourette's Syndrome, all of which give us pause for thought.

I told my Dad this was going to be a journey. I have three PG children and DGS is just as smart, he just seems to have a few challenges. I started this to try to get a handle on his educational needs and that is still the goal. FWIW, the school is being very supportive, they gave him informal accommodations and will have copies of all his testing from them available for the neuropsych. They have said they will do whatever is necessary to make his schooling appropriate and hopefully, enjoyable.

leahchris

Why is his teacher reluctant to do the scales? I hope she'll reconsider! Whether or not he ultimately is diagnosed with ADHD, her input into his current functioning at school is a valuable data point - I hope she'll reconsider!

It sounds like he is in a great school!

polarbear

ps - that's interesting about anxiety possibly causing deficits in working memory. My ds responds to stress with anxiety, and when he was first in school with undiagnosed challenges, he was so frustrated and stressed out he became anxious to the point of having panic attacks and was diagnosed with anxiety disorder during his neuropsych eval. He also had relatively low scores on working memory at that first eval. Once we had his diagnosis and accommodations in place, his severe anxiety disappeared almost overnight - it was (is) still there but under much less stress it's impact on his life is much less severe. He went through a second neurospcyh eval in 5th grade and at that time his working memory scores went way up - I wonder if the first set of scores that were low was related to anxiety. Interesting!

His teacher says he is not so disruptive and he can be re-directed. She really just hates medication. She says some of her students have had such bad experiences with the meds that she would rather not do the scales. She also believes most of his problems are related to anxiety and being afraid to fail (perfectionism?). She will do the scales she just wants to make sure we get a good diagnosis, and don't just medicate without thought.

However, she also thinks my DGS who has had at least one existential crisis (q: what would happen if God never existed? HIS ans: there would be nothing and dark) and worries about black holes hitting the earth is just an average or slightly above 6-year-old! So, we will see. Sometimes I wish for an average or slightly above child! I'm told there are easier to parent! LOL!

Welcome back Leahchris -
I can only speak to my own family's experience. I was reluctant to try the stimulent medication and delayed for years. DS15 finally insisted we try it at age 12, and he's been so much happier since that point. His processing speed (not due to perfectionism in this case, he's just real real slowpaced guy, as is DH) is just under average, and wasn't affected by the medication, which suprised me. His working memory however, took a big jump after the medication, from about low 110s to high 120s. This has been a huge help to him in his daily life in compensating for the slow processing.

Before - he was slow and 'not moving' in turns.
Now - he is like a glacier, slow moving and absorbing everything in his path.

Before - he could only learn what HE ws interested in learning.
Now - he prefers to learn what he is interested in, and often self studies topics outside of school off the Internet, but now he can tolerate topics which are not as intrinsically interesting, and topics which he doesn't automatically excel at.

I don't think that all the change was due to medication, we worked and worked at organizational skills,etc, at home and at school above and beyond what most parents would be able to concieve of, but, in the end, it took the medication (or maybe just time, who really knows?) to get it to all come together.

As an aside. My son is also on the 'anxiety side' of things, although not formally diagnosed, it was clear that most of his acting out in early elementary days was triggered by him trying to get in control of himself and avoid his fears. For him, having a brain he can rely on has been key in reducing his fear level. I know that anxiety can cause the symptoms of ADHD as well.

Ultimately as parents we will never know all the answers in advance. I think we have to analyse the availible resource, the particular situation, make a plan, and try it out to create more data.

It sounds like this year's teacher is very caring, which is great. I love that she doesn't want to see kids medicated to make her job easier. But I think that for PG kids (which your child sure seems to be) the goals is to help them keep up with their brains, not damp them down. Ask her to at least fill out the form.

I'm also excited that the vision issue was detected. Hopefully once that is handled the reading level will increase. I wonder how your son does with audio books. With my son, he 'listened' at an unusually sophisticated level, even though he wasn't an early reader. If you haven't used audio books much, I encourage you to use them in hopes of keeping his 'love of language' moving forward while he waits for his vision to kick in. I'm also wondering how your son's reading skills are if you quiz him orally on the various aspects of reading, as in, asking him to take a word, and swap various letters in and out to see what new words that makes, or asking him to spell words orally. My son complains that when he was little, and wanted to learn to read, that I always dragged him over to pencil and paper to 'show' him stuff and that I should have asked him more questions.

Smiles,
Grinity

I hope she will fill out the scales without bias. Just as it is not a teacher's place to recommend (or insist on) meds, it's also not her place to say that meds are always a bad idea. She is not your medical or behavioral expert, and she does not have the authority to make that call.

IMO you should find the most expert doc you can, have them evaluate all the evidence carefully, and work through the available options with that doc.


True in our DS's case as well.

DeeDee

Grinity,
Thanks as always for the insights. His teacher has a 'listening center' in her classroom where they read along with audio books. It is one of his favorites. Also, I read to him every day. His listening comprehension and spelling are way above grade level. His silent reading comprehension is where the problem may be, and may remediate with the vision issue.

The really wonderful thing is that in the last few months he has developed an ever-increasing love of books. The kdg books were boring him to tears, but he got a reading award last night for having read more than 75 books in class this year! Really surprised all of us!

I have finally found books he loves, such as Ready Freddy and Nate the Great. He helps me read the first paragraph and I finish it from there. We have a lot of fun reading together.

He also wants a brain he can rely on. He says sometimes his mind goes crazy, and it bothers him a lot.

DeeDee - His teacher will fill out the forms and she will do it without bias. She is that kind of teacher - the one we wish we had when we were little! We have an intake with a neuropsych on the 21st, and will go from there.

Thanks for taking the time to respond.

Leah

I'm so glad you have a great teacher, but to be honest, it makes me worry more - what are the odd that the next year and the year after that the teacher will be as amazing. DS also had an amazing teacher - 3rd grade. But even highly skilled, well meaning teachers were very very hard on him.

I loved the Nate the Great books as a kid. I think there is also a series called 'the great brain' he might like. And try some Bruce Coville Magic shop books. Also pick up something meatier, such as Harry Potter and the Sorcerer's Stone for a read aloud, if you haven't tried that yet.

Smiles,
Grinity