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Absolutely essential. (I thought you already had a neuropsych, or I would have recommended this earlier.) A school psych does not tend to know what a neuropsych knows.


Have the neuropsych do the WISC.


I've never seen any evidence that this kind of program (or Brain Balance, etc.) works-- and there are a lot of people who say it's quackery. I have no firsthand knowledge of their prorgram, but I am skeptical.

My DS likes Lumosity ($100 a year for 5 people to subscribe), which seems to do the same kind of thing. We treat it as a video game, not as therapy, but we don't think it will hurt him.

DeeDee

Hmm. I don't think either of my two have issues with automaticity. DS8 has an ADHD combined type diagnosis and DD10 has characteristics and behaviours but no formal diagnosis. DS8's biggest ADHD Achilles heel is inattention. He's also distractable, impulsive and hyper, but no significant automaticity issues.

Yeah - that was my original plan. BUT, DS likes the school psych, she likes him and he loves to get out of class to do the tests with her. It also seems so much easier on him because she spaces it out over several days instead of one sitting, which seems so much easier on him. I don't know. I am torn - obviously it would be cheaper for me too since the school psych will not cost me money (other than what I am already paying in taxes.
Not sure what to do.

marytheres, most kids seem to enjoy their neuropsych evals. It is another round of testing, but all of the tests are different in some way, most are short in length, and our neuropsych gives children breaks between tests. Some psychs will break up the testing into multiple sessions over several days, but the typical neuropsych eval is done all in one day for a reason - the neuropsych wants to see how your child copes at different times during the day and with increasing number of tasks etc. Our testing was timed to mimic the school day (start, end, lunchtime) pattern - it didn't exactly overlap our kids' schedule, but the general idea was this is an educational exam, and part of understanding how our child is coping at school includes seeing how they cope over the course of a full day of "work".

Re the cost - you might be able to get insurance to pay for at least part of the eval. We were told "no" by our insurance at first, but we were able to get it covered. The keys (for us) were having a referral for the eval from our pediatrician, calling the insurance company to explain that there really were no in-network providers that could provide the same service, and also having the neuropsych's office staff help with codes that would work.

More in a minute....

polarbear

Thanks for weighing in! Yeah - this is what gives me pause too ...DS' challenges do not seem to be attention, distractibility, impulsivity, etc... It's definitely with working memory (although it could be argued one doesn't remember based on one not paying attention in the first place as opposed to something being wrong with his memory). However, the fact that DS can do the digit span test forward really well but not backwards really well - sort-of adds more fuel to my not seeing the memory issues as being related to attention... He scored quite high on digit forward, abysmal on digist reversed. If this were due to attention, it would occur on both - no? Plus, I (as well as others) simply do not see big issues with attention, per se. There are times when he is in creative mode and he needs to get a story out, he is spacey. But I have noticed he is getting better and better on that. Like he sets aside time to create his story and "puits it away" in his head until then. Anyway, the big problems are not that 'DS has trouble staying on task.' Those aren't the notes/emails coming home. The notes home are "DS has three jobs to do in the morning and he can't remember to do them, without reminder." And this is true - I have SEEN this myself and it is very annoying. He used to have somewhat more difficulty "staying on task" before his vision was treated and his writing accomodated.... Now the school and I (as well as he, which makes a huge difference) know the signs of when his eyes are bothering him (his eyes water, hurt, turn red - happening so much less and less now with the VT) and can give him a break, also same with writing - when he gets fatigued (and we now know the signs) he gets a scribe and has no trouble continuing on task. The teacher has said herself - "If he could just remember the things he is suppose to do automatically throughout the day and keep his things organized, we'd be golden!" This is when the lightbulb went off in my head because I got that email the same day Polarbear mentioned on here the fact that automaticity of forming letters never seems to come to a dysgraphic and the day before I believe it was I got the word form the school psych that she sees 'dysgraphia' in DS's testing.

Dyspraxia (more often called Developmental Coordination Disorder when diagnosed in the US) can be variable from person to person. I'd recommend googling dyspraxia+symptoms for some initial info - I'll try to post some useful links later today. I can tell you how it impacts my ds, but it may impact another child in a very different way... it's tricky! For my ds, the most obvious symptom is his handwriting challenge (which, for him, is fine-motor related). Other ways he's impacted might seem like laziness or slowness if you didn't realize he is dyspraxic or didn't understand what dyspraxia is. For instance, his overall movements are simply slow. Not glaringly so, but in the way that if he was usually moving at a speed that is a little more typical, and then you were with him trying to get ready to go somewhere and he moved at the speed he always moves at, you might find yourself hurrying him along in a big way. And he doesn't really see that he's slow, he feels like he's rushing and can be moving at the speed of a glacier. One example - we were late for school one day and I was hurrying my kids along to get into the building fast - when I do this with my other two kids, they speed up. DS wasn't speeding up, and he was lagging farther and farther behind. In exasperation I turned around and told him "Run, ds, run!"... and he (while walking slowly) replied "I AM running!"... and he really thought he was. He's not terribly coordinated at sports and prefers individual sports to team sports - this is getting a bit better as he matures (his enjoying the team sports, not his coordination). He still has a hard time telling which direction is which and confusing left and right. He didn't learn how to tie his shoes until he was in 4th grade, and then he forgot again over spring break when he wasn't wearing shoes that tied. He learned how to write cursive in 4th grade and later forgot how to do it. So for him, lack of ability to develop automaticity of skills requiring brain-to-muscle coordination in the same way most NT kids develop it is a big part of his dyspraxia. Some children with dyspraxia also have apraxia (speech is affected). DS doesn't have apraxia *now* but his neuropsych believes he had apraxia as a young child and no one caught it then. He didn't learn how to talk until he was over three years old, but once he did start talking it was in complete and complicated sentences so we never thought much about the not-talking or not-making sounds earlier as anything other than cute and quirky. He was also late learning how to walk, late learning how to crawl and didn't really want to crawl once he started crawling. There is such a large range of what is developmentally "normal" that we never saw any of his "late" early milestones as anything other than normal until he was older and we had other symptoms that correlated with them into something outside of "normal". DS is also extremely challenged with organization, and infamous for "losing" things that he's standing right on top of.

He also has some odd sensory quirks, and he feels like his stomach is full long before it's full, so he'll eat a tiny bit at a meal, think he's full, and an hour later be starving and need to eat again. I would have chalked this up to just typical kid stuff, except that a friend of mine who lives in another part of the US also has a child with dyspraxia and she had some issues surrounding eating and her dr told her that disconnects between the brain and stomach like this are symptoms of dyspraxia.

Lastly, my ds has an expressive language disorder - he's challenged (extremely) with putting his thoughts into written expression and also to a certain extent with verbalizing some types of expressive language. I think it's possible this is tied in with his dyspraxia.

The thing is - not everyone who is dyspraxic is affected in the same way, not every symptom is going to happen for every person.. so it's complicated!

(ps - sorry that's so long and rambling!)


I think this is an *excellent* idea - and I think it's a good idea to have the neuropsych administer the WISC when you have him retake it.


Per my other reply, most kids find the neuropsych evals fun, although they may come out of it tired at the end of the day. It's very different from the VT sessions and evals - my kids have found those to be exhausting - but they are all "focused" (can't think of a non-eye-related word lol!) on vision, using your eyes, and your eyes get very tired. The neuropsych exams involve so many different types of short-time tests with breaks in between and a lot of talking and movement so that it's not tiring in the same way the VT things are.


I have found private testing to be much more valuable than the school. The main reasons:

1) You get more time and more insight from the neuropsych eval - you have an input meeting and a follow-up meeting to review the report *in detail* after the testing. You can continue to call up, schedule follow-up meetings until you fully understand what the neuropsych found.

2) More in-depth testing - there are tests that neuropsychs administer that school psychs don't. For instance, my ds has an obvious dip in processing speed. At school, they see that for what it is - an obvious dip in processing speed. At the neuropsych, there were additional tests to determine - is it fine-motor related, a visual issue, etc. We came out of the neuropsych knowing not only that ds was dsygraphic, but which type of dysgraphia it was (fine-motor). There were also executive functioning tests etc, and an ADHD eval including behavioral surveys from parents and teachers.

3) The neuropsych eval includes a parent interview which includes a detailed developmental history - this is where all those things we never recognized as parents from the early years and instead just thought of as cute quirky little things... were seen in a totality by a professional who realized that all together they pointed to a history of dyspraxia, not just randomly occurring cute little quirky things.

4) Recommendations that are wider and deeper than the school will give you. The school is only going to recommend services that they are required to provide, which means your child has to fall below a certain level of functioning. They are also only recommending services supplied by the school district or by people contracted by the district. A neuropsych is going to make recommendations based on what your child *needs*, not what the school district can (or is willing to) provide. We were given very specific recommendations for the types of therapies etc that would benefit our ds, as well as recommendations of *which* private professionals would be a good fit, which would be easier to get in to see, which were worth waiting for etc.

5) Our neuropsych also gave us a forward plan for what our ds would need as the years go by - not just for school, but for life.

6) (for us) Help with teasing out issues like "is this ADHD or is it dyspraxia or is it something else".

7) A credible report that we were able to use (and continue to use) when advocating at school.

Lastly, although it's expensive, I'd look at how much you are spending now and may very well have to spend later on for your ds - outside therapies etc add up over time, even when you're only paying a deductible. They are also a huge investment in time (your time and your child's time). For us, having that neuropsych advice to guide us as we made decisions about therapies etc was invaluable.


I don't know anything about this program, and haven't taken a look at the link. Just fwiw, I think that this is an example where it was really helpful for us to have the neuropsych advice *first* before making decisions about programs like these. We were told by our neuropsych that WM an area that can improve over time and sometimes does improve during early-middle childhood, and we saw that happen with our ds *without* programs like this. He's also had a gradual improvement in executive functioning skills, which our neuropsych predicted might happen as he moved toward the early teens. Processing speed, however - our neuropsych believes that is something that most likely won't change... but she had very specific recommendations for how to *cope* with it, how to work-around the challenge, how to remediate what could be remediated, and how to approach AT etc.

polarbear

I don't know how this would play out for a child with ADHD, but fwiw, I am fairly certain there was a discrepancy in this on my ds' testing. I don't have it in front of me at the moment, so I'm just going from memory, but I do remember having the same question!


My ds looked "spacey" too (still does) when he needs to get something out in writing and can't. His 2nd grade teacher thought he was distracted and daydreaming, and that's why she thought he had ADHD. Even two years later when he was having an IEP eligibility eval at school, after we had his neuropsych report outlining his challenges with handwriting (but before we knew he had an expressive language disorder), the school psych tried to explain away the times he was sitting at his desk doing nothing as ADHD rather than what ds was telling us at home - he didn't have a clue what to do so he was just sitting there. He did eventually get distracted because no one was helping him and he didn't know what to do - but he didn't get distracted first, and distraction wasn't what was causing him not to be able to do his work.


This is very true of my ds - more so when he was younger. In 4/5 grade he had *so* many missing homework assignments that I knew he'd completed, I saw them go into his backpack to go back to school, his classroom has a very obvious "homework in" basket, a very set routine, kids come in, put take their coats and backpacks off, put their homework in the basket, teacher gives "reward" for homework turned in etc... ds couldn't complete that loop. There were so many examples of things at home that we had to remind him to do over and over and over again even though they were the same things each day. It was so amazing to me when his younger sisters just seemed to automatically catch on and do those same things for themselves. When he started middle school I went into the building and helped him check his locker every day after school, went through what his homework was and what he needed to bring take home to do it to be sure it was really in his backpack etc. I don't know if these are things that are typical of ADHD, but I *do* know these are things that are very typical of dyspraxic children - they are symptoms of the challenges with developing automaticity. On a hopeful note, repeat repeat repeat and then repeat again - has worked for my ds over the years. Just not anywhere near as quickly as it does for nt kids.


This will get better as he gets older. And it's good that he's got an understanding teacher too. My ds still gets thrown off by changes in schedule, but as he's gotten older he's found some of his own work-arounds for keeping track of things like turning in homework, keeping track of what his homework will be each day and making sure he has everything he needs to do it. It's helped when he's been in classes where the teacher is consistent with routines.

Gotta run - I hope some of my rambling helped!

Best wishes,

polarbear

This board is amazing and Polarbear you especially are gem... I can not tell you how much you have helped me this past year. Thank you.

Yup. THIS is it. This simple thing my DS can not do. I think to myself "this is preposterous - I could train my dog to this." Seriously. Why can't my child? Particularly a child who creates the most amazing stories and 'books' and has amazed people with his his speech, vocabularly and ability to articulate since he was 2. When he was in pre-school all the other children could do it after a few months - not my DS. I used to get so embarassed. Other parents would chat and wave as their child would do the routine. Not my kid, my kid was the only one (as far as I could see) that couldn't put his jacket away and folder in the basket. I was relieved in Kindie when I could just drop him off in the carpool line and not have to deal with this problem every morning. But of course the emails home would report it to me...it seems eventually an aid had to help him every morning. I figured after 2-3 years of having essentially the same routine he'd have it down by now... But, no. Note from teacher justy this week... no he can't do this on his own - she or an aid helps him. every day.

Okay so making an appointment with a neuropsych - technically, he is no longer spoiled for the WISC after April. Fingers crossed that by the beginning of next school year I'll have it "all figured out" (his problems identified and diagnosed, his accomodations and remediations) for my DS