Gifted Issues Discussion homepage Forums Parenting and Advocacy Should I get DS tested for ADHD?

I'm extremely wary of an ADHD diagnosis. Partly because having worked in the school system, I have seen how with certain teachers, that serves as a "red flag" that this will be a problem child. Also, because while I do believe there are plenty of people who genuinely have ADHD, it is seriously overdiagnosed - for any kid who has never learned to sit still, or even kids who are acting age-appropriately. So I'm hesitant to have any testing done on DS9. However, here is the problem. He gets distracted by the tiniest things. He absolutely can not do his homework if the kitchen table is cluttered (and since I'm not much of a housekeeper, that's pretty frequent). If you get him the right book, he can sit and read for hours. But if he is told to read a passage or a book, he loses interest and by the time he's done, can't even tell you what it was about. He recently did AIG testing, and his scores were surprisingly low. (This is not just "proud mommy" talking, his teacher and the AIG teacher both said they didn't think his scores were accurate. However, after the testing, he rattled off about twenty different flags that were on the wall of the room where he was tested. That makes me think he was staring at the flags instead of focusing on his work. His grades are good (mostly A's with a B here and there) but his teacher and I agree that he could be doing better. He doesn't get into a lot of trouble at school, but he squirms a lot. (Even in preschool, his teacher said he used to pace around the room while he was reading).
So I'm thinking it COULD be ADHD, but it could also be just normal boredom. Or just acting like a 9 year old. And if I do decide to have him tested, how do I go about doing it? Is that something the school will do? His doctor? Would it be better to go to someone OUTSIDE of school, so I can decide whether or not it's something that should go on his record at school? (I'm also worried about treatment, if he does have ADHD. I don't want to automatically shove drugs down his throat without exploring all options, and I have seen so many teachers who strongly urge parents to do just that, just to make their jobs easier.)
Everyone agrees that he is a smart kid - but if he is getting good grades, even if I think they could be better, should I just leave well enough alone? If not, how do I approach it?

seaturtle, I went back and re-read your previous post about your ds. What you've described above - distraction with clutter in the field of vision, inability to retain what he's read, distraction in the classroom - sure, those could all be symptoms of ADHD, but they can also be behaviors caused by difficulty with vision - and your previous post mentioned your ds had been evaluated by a behavioral optometrist who found he had visual processing issues. I understand from what you wrote in the previous post that you may have been skeptical of the optometrist's assessment, but as a parent of a child who's had the very same type of behaviors and issues and who used to have people suggesting all the time that she had to have ADHD based on her behaviors... my dd didn't have ADHD, she had vision challenges. I was a total skeptic that things like tracking/convergence/etc could be causing major issues, but they were! I was very doubtful at first, but we took a chance on vision therapy and it made a huge difference in my dd's life. Her reading ability skyrocketed, she started actually *loving* to read, and most of the distracted behaviors that looked like ADHD went away.

Sooo... just my two cents, but rather than worrying about ADHD at this point - when your ds is doing well in school and it doesn't sound like other people are concerned about it (teachers etc), I'd think through the vision info you have first and reconsider what the optometrist recommended.

Also, just wanted to throw this out there - my dd had really REALLY bad vision issues (including double vision)... and at 8 years old, none of us realized it, including my dd - she thought everyone saw the world the way that she did! She also had 20/20 eyesight in each eye at the time, so her regular eye dr didn't find any issues with her eyes. The key was her eyes, although they were individually seeing 20/20, weren't focusing together.

Best wishes,

polarbear

ADHD is rarely just about attention... it typically manifests in nearly ever facet of life. Here's a list of a few things my ADHD hubby & son have problems with, that I would consider very ADHD...

- Forget why they entered a room, opened the fridge/pantry, etc. They will suddenly stop, look confused, and just stand there trying to remember wtf they were doing.

- Trouble with multi-step directions. DS, in particular, can't handle more than 2 steps at a time or he gets lost/distracted before he can finish.

- Routinely misplaces things... shoes, belts, lunch boxes, glasses, cups, etc, etc, etc. This is nearly daily.

- In ability to consider consequences/impulsive-ness. (This is mostly just an issue w/DS.) He had trouble taking consequences into account when making decisions. Immediately afterwards he will realize what he's done, and regret it, but no amount of after-the-fact punishment/consequences can prevent him from making impulsive decisions on the regular.

Both my DS and DH CAN maintain attention on tasks they enjoy. No amount of distraction can pull DS away from a good book, or DH away from a favorite video game. Hyperfocus all the way.

I wouldn't "leave well enough alone." A smart kid with ADHD may develop the sense that he's not good at things, when he really is very talented but truly can't muster the executive functioning to get things done. The self-esteem issues are real. Lots of late-teens and young adults with ADHD will self-medicate with alcohol or drugs if they get frustrated enough, which all of a sudden makes Ritalin look like not such a bad deal if prescribed responsibly.

I'd not trust school to evaluate for ADHD, nor would I ever let the regular pediatrician medicate my kid for this kind of thing. A neuropsychologist can do the right kind of testing; ours worked in tandem with a developmental pediatrician, which was a good combo for us (let us look at physical and behavioral factors). We have a developmental ped. we trust who prescribes meds for us; she has seen a lot of kids, and she knows we are conservative in our outlook about meds, and she tries hard to balance all our concerns.

Nobody I know of has medicated their kid because it's fun, or to make a teacher happier. Usually it's because the kid is really suffering serious self-esteem issues because he can't manage his own behavior and attention, and the medication is a last resort of sorts. As I understand it, the best practice for an elementary-age kid is to use medication and then, because the kid is now focused enough to learn well, you can teach the missing skills.

DeeDee

This list makes me think I should be tested for ADHD.

I was excellent at the pick things up and move them somewhere else game.

Generally, I only had some vague sense that I had touched said object at some point previously.

The problem arose when whatever I was randomly moving didn't belong to me.

Ah, childhood memories.

Seaturtle he sounds just like my DS8 (dx w/ADHD combined type).

I'm not sure if an ADHD diagnosis is really helping us. It would be different if I wanted to try medication, but I'm holding off on this for DS. I'm not against medicating, but I don't think it's the answer right now. (Anyway, that's a whole other thread).

As for the testing, we used a private psychologist. It's fairly pricey ($2,000) but luckily my husband had some coverage (we ended up paying about $600 out of pocket). This gave us the opportunity to withhold it from the school if we chose to do so.

We ended up submitting it, because he was also diagnosed with a language processing disorder, and that diagnosis gets him time in the school with a SLP.

Overall, I'm not happy... mostly with the lack of variety in the funded treatment options available to the diagnosis (there's just medication, medication, medication).

Here's the thing that makes me crazy... there really are other ADHD treatment options out there, but they're not covered under our medical system (I'm in BC, Canada). For instance, friends of ours decided not to medicate their daughter and opted for cognitive training instead (ie interactive metronome, etc). It cost them about $8,000, but IT WORKED. She's like a different kid. Why isn't that covered by medical?

Anyway, you don't need a diagnosis to pay out of pocket for cognitive training. The only thing (that I'm aware of) that an ADHD diagnosis can help with is access to medication if you decide to try that route.

Medication is the only covered treatment for ADHD because it's the only legitimate treatment for it, as far as science is concerned. There have been some promising treatments, but there are no peer-reviewed studies showing any of these cognitive training/neurofeedback-type treatments cure or have long-term effects on ADHD.

Having said that, ADHD is almost exclusively diagnosed via matching symptoms to a list (subjective, easily effected by bias), as opposed to brain scans (obviously expensive and rather involved.) This probably results in a lot of kids getting diagnosed that do, in fact have some sort of developmental delay in regards to executive functioning, but NOT full-blown ADHD. ADHD actually shows up quite clearly on brain scans... and I'm not sure I believe things like cognitive training or neurofeed back can alter the brain the way they claim in a few short weeks/months.

Pet theory... If you start from the overexcitabilities concept, your brain gets oversaturated with information so you need very selective control to not be overwhelmed. Once you have that control, you may have the ability to focus or not focus as you decide.

BUT, that isn't the "normal" state, focus would normally be much more automatic. Once focus is under executive function control, you may not be wired for ADHD but to all intents and purposes you act as if you are, but you can also pull away a ton of resources from other regular mental activities (e.g. reinforcing todo lists or people's names, awareness of space, reading other people's non-verbal communication, acquiring physical skills through observation, spacial awarenesss, encoding automaticity, etc.) to amp up your smarts even further.

Under this framework you can easily achieve five blind men describing an elephant in diagnoses. Visual processing disorder, check. Dysgraphia, check. ADD, check. Pragmatic language disorder, check. Maybe that's why I read of some pediatricians using drugs to diagnose, because the answer is quicker that way.

If it is a valid framework, then cogntive type behavior training on redeveloping automaticity and attention splitting may be a great generalized first step.

My apologies for the fly-by here, but fwiw, my insurance was willing to pay for 6 months of neurofeedback as a treatment for ADHD.

polarbear