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    keet #134146 07/16/12 08:09 PM
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    ADD would present itself with non-auditory inattentive issues such as failure to focus on a difficult task (puzzle, worksheets, getting dressed-lol). You would usually also see difficulties with organization (school papers, closet, always losing things)beyond the typical child.

    keet #134148 07/16/12 08:24 PM
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    ADD can look like CAPD. However, if you get a good psychologist/audiologist, there are tests that can differentiate between the two. I forget now, but on the CAPD testing my son had as well as on the WISC, there parts of the test that required the ability to really concentrate, which he aced. Both the psychologist and the audiologist highlighted how these parts of the tests differentiated the two.
    My son has excellent focus and concentration, esp. when it's quiet. In a classroom, he can sometimes get lost when it is noisy. Our audiologist said that she thinks his auditory processing disorder will catch up and normalize to that of other kids by the time he hits puberty. I hope so! We are doing weekly piano lessons (for two years) and he will also start viola with the school orchestra next year.

    keet #134152 07/16/12 09:52 PM
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    My son, meanwhile, has excellent focusing ability, and the more difficult a task is, the more he is able to concentrate (generally speaking - there's the odd exception).

    He's an enigma - we've had many different pros disagree as to his diagnoses. Our psychologist has suggested ADHD combined type and Expressive and Receptive language disorder, which is from what I understand the linguistic component of CAPD. Meanwhile he's had four normal hearing tests which have ruled out any ear problems.

    Our pediatrician meanwhile disagrees with the ADHD ("I've seen so many kids with ADHD and he's different."). I'm on the fence with the ADHD... some days, sure; others - not a chance. The language processing I believe completely (even with the fact that he reads above grade level in English wink )

    Anyway.

    ADD/ADHD and CAPD can be co-morbid/overlapping much the way that ASD and SPD can be (both of which school staff also thought my son has, but the docs said no way).

    I read somewhere (Scientific American Mind, I think), that ADHD and CAPD can have identical symptoms and the diagnosis the child gets sometimes depends on the specialty of the diagnostician (i,e, psychologist Vs. audiologist).

    Meanwhile our psychologist said "oh no, he doesn't have CAPD." (She's the one who diagnosed the ADHD). Then in the next breath she admitted that she didn't have all of the testing materials that an audiologist would have (well then how can you say with certainty that it's not CAPD?) Arrgh.

    I don't have a problem with her work - I have a problem with testing & diagnosis in general: As my family doctor says, psychology is generally just the practitioner's opinion.

    Surely science can do better - you'd think there would be actual medical tests available to pinpoint which brain region(s) is/are deficient. With my layperson's understanding that ADHD lives in the prefrontal cortex while language lives in the left hemisphere, & Broca's & Wernicke's areas, and the primary auditory cortex being located in the temporal lobe, I find the idea that disorders of these areas can be "interchanged by misdiagnosis" really frustrating.

    Meanwhile we spend all these hours and dollars just to get someone's opinion...

    (sigh)

    Last edited by CCN; 07/16/12 10:51 PM.
    keet #134209 07/17/12 07:19 PM
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    CCN...I, too, wish there existed a specific test...especially being a clinician treating kids. The brain imaging evidence of ADHD is inconclusive, sometimes even demonstrating opposite findings. I was reading information from a psychiatrist (sorry forget name) who was discussing the proposed changes in the DSM5 that is due 2013. He specifically noted the difficulties in diagnosing ADHD and proposed that the diagnosis umbrellas a number of syndromes which could account for the brain image variability....yes, it is often a guess.

    One thing I wanted to mention on this thread is the importance of medical rule-outs when ADHD/other behavioral issues are suspected. Simple tests of
    lead levels, thyroid function, certain vitamin deficiancies, celiac or even PKU along with more complex genetic testing if warranted (fragile X,Klinefelter's ) are really minimally invasive. I can't tell you how many times I have to send a child back to their PCPs for a proper work-up.

    Last edited by Evemomma; 07/17/12 07:24 PM.
    keet #134213 07/17/12 09:44 PM
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    Well, definitely, get an audiology exam for hearing before allowing anyone to prescribe medications for ADD/ADHD. Hearing loss is frequently missed in the screen at the doctor's office.

    Evemomma #134215 07/17/12 10:16 PM
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    Originally Posted by Evemomma
    CCN...I, too, wish there existed a specific test...especially being a clinician treating kids. The brain imaging evidence of ADHD is inconclusive, sometimes even demonstrating opposite findings. I was reading information from a psychiatrist (sorry forget name) who was discussing the proposed changes in the DSM5 that is due 2013. He specifically noted the difficulties in diagnosing ADHD and proposed that the diagnosis umbrellas a number of syndromes which could account for the brain image variability....yes, it is often a guess.

    One thing I wanted to mention on this thread is the importance of medical rule-outs when ADHD/other behavioral issues are suspected. Simple tests of
    lead levels, thyroid function, certain vitamin deficiancies, celiac or even PKU along with more complex genetic testing if warranted (fragile X,Klinefelter's ) are really minimally invasive. I can't tell you how many times I have to send a child back to their PCPs for a proper work-up.

    It amazes me that these tests aren't routine (I'm guessing it has to do with cost). My DS8 has been tested for celiac and gluten, at my request. I'm glad you mentioned the others - I'm writing those down smile The CAPD test this friday was also as a result of my insistence: I had to ask twice for it and provide examples of his speech oddities and language comprehension difficulties before we were referred.

    I'm not anti-meds - not at all - I think some kids are saved by them. I just think they should be last on the list after all the medical rule-outs have been done. Thankfully my son seems to be fine without them so far. Mind you, I think he's easier than some (either that or I'm just used to him and my perception of what's "easy" is off, lol)



    Last edited by CCN; 07/17/12 10:22 PM.
    jack'smom #134216 07/17/12 10:27 PM
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    Originally Posted by jack'smom
    Our audiologist said that she thinks his auditory processing disorder will catch up and normalize to that of other kids by the time he hits puberty. I hope so! We are doing weekly piano lessons (for two years) and he will also start viola with the school orchestra next year.

    That would be awesome... I have my fingers crossed for you smile smile I've heard of this as well, that audio processing issues are sometimes just the result of a delay that eventually catches up.

    We do piano lessons too. I think it's really, really good for them. My son loves performing at recitals. He's such a little ham, lol

    CCN #134234 07/18/12 07:04 AM
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    Originally Posted by CCN
    I'm not anti-meds - not at all - I think some kids are saved by them. I just think they should be last on the list after all the medical rule-outs have been done. Thankfully my son seems to be fine without them so far. Mind you, I think he's easier than some (either that or I'm just used to him and my perception of what's "easy" is off, lol)

    Amen:)

    I also forgot to mention blood glucose levels, especially for kids with a lot of mood lability - not to mention a thorough physical exam including simple neurological tests (in office). Sleep disorders are another hidden culprit. Also common meds such as Zyrtec, steroids inhalers, albuterol, and predinsone can be a source of troubles.

    And often it's the convergence of medical issues exacerbating things like ADHD...but ignoring medical issues and only utilizing pyschotropic mess is an all too common practice with kids and adults alike (use of antidepressants in adults without exploring other causes of depression).

    I'm glad you have gotten some helpful medical rule-outs.




    keet #134388 07/21/12 08:56 AM
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    My son is going for a neuropsych. His pediatrician said he appears highly gifted but must also be concerned about ASD or something else if he is sending my 2 year and and 8 month old son for that kind of exam.

    Do children with ASD make eye contact? Are they emotionally sensitive at all? My son fits some of the characteristic but not others.

    keet #134414 07/21/12 05:49 PM
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    Hi Isaiah09,

    The current diagnostic criteria for Asperger's Syndrome are here: https://www.firstsigns.org/screening/DSM4.htm#AS

    I find Asperger's the most likely among the autism spectrum diagnoses to be considered by a neuropsych, because it sounds as though your DS didn't have significant language delays, and certainly not an IQ impairment. But there are links to diagnostic descriptions of all the various shades of ASDs from the top of that web page.

    Good eye contact alone is not enough to rule out an autism spectrum disorder. They are looking for clusters of features that add up to a social disability: a failure to engage and relate to peers well, an inability to adequately understand the thoughts and feelings of others, impairments in social language, impairments in nonverbal communication, all these sorts of things can be part of the picture.

    There is so much folklore about autism these days (i.e. "he can't have autism because he ... fill in the blank"), and a lot of it is not correct or not that useful for a family wondering how to proceed. Expert advice is much better.

    Don't panic. See what the neuropsych says. Make sure they do a thorough range of testing. Ask them lots and lots of questions, and make sure you don't leave after the followup meeting until you understand exactly what THEY think you should do next (a new school that's a better fit, or special services, or whatever-- a clear path forward should be the goal.)

    HTH,
    DeeDee

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