Gifted Issues Discussion homepage Forums Twice Exceptional What is this? I could really use advice.

I could use some help. I thought dd would grow out of this, but it doesn't seem to be happening. I scourer the internet trying to figure out what it is but haven't come across anything that fits. I'm not looking for a diagnosis for her, I just want help figuring it out and to be able to help her.

Okay this might be long.

DD is 6, when she is with DH and I, or my mom, or a few of our friends who she has been around a lot, she talks a ton. In new situations, new people...especially in a group, she is extremely quiet and withdrawn.

In groups of kids she stands on the sidelines and watches and then tells me she feels left out. I have noticed that she does not answer kids when they talk to her in a group setting. When I talk to her later she says "I didn't hear them." Her hearing is fine, it's been tested and she hears me on the phone from the other room and comes running to put her 2 cents in. In groups she has a hard time following the directions given by the teacher, leader, etc. It seems like she doesn't hear them or comprehend them. The leader has to go up individually and give her the directions or she just stands there. One on one, again, no problem hearing and following the directions.

Another thing I have noticed, DD can NOT remember names. Unless she is one on one with a person and hangs around them, she can not remember names and will tell me about the person by describing them, down to what they were wearing the first time she met them. She has been in Brownies all year and still doesn't know the girls in her troops names besides 2 of them who she hangs out with a lot. If I mention a name, she asks which one that is and starts describing.

When she was younger, I thought she might be on the spectrum. A psy she saw at 4 said she wasn't and the behavors stemmed from giftedness.

She is still really uncomfortable with loud noises, often has her fingers in her ears in groups, crowds, even with a piano playing. She has a hard time looking at people when she talks, she looks down, over your shoulder, etc. I have talked to her about this but it hasn't helped and she says it feels uncomfortable.

So we did have her evaluated, but just IQ and achievement testing and she scored high enough for DYS but with WM and PS just on the high average range.

Please give me some advice. I just want her to feel comfortable. I want her to be able to make friends. I want to know what is going on.

Have you had a CAPD evaluation? Some of those symptoms can be related to Central Auditory Processing. You should read The Mislabled Child by the Eides. It has chapters on CAPD, vision, dyslexia, autism, etc. that should help you narrow down what issues she is having.

I second CAPD. I will tell you that DD had some flags for this and she passed the eval with flying colors, though, even though I still see some things that make me wonder. I have wondered if her giftedness, particularly her outstanding memory, obscured some things.


This echoes a concern DD's 2nd grade teacher expressed and is part of why we evaluated her. The teacher also said DD had some trouble in large groups--seemed tuned out or confused.

I found the book mentioned above really helpful, also "disorganized children":

http://www.amazon.co.uk/gp/aw/d/1843101483

This one is not aimed at giftedness but at multiple disorders and how they present - including discussing that a child who's borderline for multiple issues can be impossible to diagnose while also being as impaired as a hold who has a classic presentation of a single condition. My DD is barely diagnosable for CAPD, dyslexia, SPD, ADD, receptive language delay, developmental coordination disorder (she doesn't quite meet diagnostic criteria for the last two, but she's close)... None are severe on their own, together she has a LOT of challenges, which I am no suggesting is the case for your DD, just that the single chapter per condition is handy for thinking "Nope, nope, maybe, yes, nope...." For us the pattern that emerges is that all her yes/maybe issues are related to/symptoms of or comminly comorbid with Aspergers.

From what you've said here selective mutism, social anxiety and CAPD are the things I would be reading up on.

We had our second DD assessed for selective mutism a few years ago, the conclusion was shy, but not unable to talk so much as unwilling to talk. The psychologist we saw was spot on with all the other traits she observed/extracted from DD in their time together so we went with that. Time has shown the "rude not anxious" assessment to be correct for our DD, but certainly selective mutism is a very real problem for those that have it.

This is exactly what I see. She seems confused and tuned out.

Portia- That makes sense, if hearing overloaded it does make sense that the body kind of shuts down.

I am going to go observe tonight at girl scouts. It is gym night- daisies, brownies, and juniors all together playing. I have watched dd before and she totally looks confused the whole time.

How do you get a CAPD evaluation done. We would probably have to leave the island and go to Anchorage I assume unless our nurse practitioner could do it? Sigh. That's kind of why I have never pushed to figure out what was going on. Lack of resources here and a $1000 plane ticket per person to get off the island makes it hard.

Are there ways to work with CAPD?

Of course you want her to make friends:)

I also suggest you look into CAPD.

Some signs of CAPD include things like: kid hears well in a quiet environment; child is very uncomfortable with loud noises; child acts deaf in a noisier environment.

You said your DD had already had a hearing test; was this test with a specialist who can test for CAPD or just the regular hearing test?

A kid who tests at the local audiologist as having normal or great hearing may hear well with each individual ear in that sound-proofed booth. However, that typical test does not test (1) hearing with background noises and (2) how the brain puts the sounds together.

An intro to CAPD and a quick check-list can be found at: http://kidshealth.org/parent/medical/ears/central_auditory.html Keep in mind that some of the indicators can be masked by being PG.

A more technical description and an exploration of giftedness with CAPD can be found from the Eides at: http://www.neurolearning.com/auditory2.htm

The good news is that there is a lot you can do if a child does have CAPD, from ear filters to teaching your kid to stand right near the teacher in the loud room, to parents not freaking out that something else is wrong with the kid:) I know a number of PG kids with CAPD.

Not sure about the name recall: does this happen when she hears names in a louder environment or is fatigued from sound, or is this common in all environments?

About friends: I would try to isolate the real issue with making friends. If this is a hearing challenge, she might just be overwhelmed and have a hard time in nosier environments. How does she do in smaller group play? Is she more comfortable playing with just one other kid in a quiet environment?

I would also wonder about playing with peers (same age and ability). Has she had the opportunity to play with other PG kids?

You asked about a number of topics. I would think it would be helpful to figure out whether they may or may not be connected. Some may relate to an underlying issue (e.g. CAPD) and others may relate to other issues (introvert prefers to play with one friend, or child is more comfortable with peers).

Just adding to the posters that I cross posted with - my DD with CAPD has not just "normal" hearing, but hearing above average across the board and can hear a full standard deviation beyond what she should be able to hear in the lower registers. With her CAPD diagnosis, she had to score at or below the 2nd percentile for two related portions of the test (any two, but there had to be two and related), she just barely met this criteria, there were other sections were she scored above the 98th and much of it was at least average, some poor and two extremely low...

When she was 5 and struggling at school I remember having this epiphany that maybe she was partially deaf. I went and asked her teacher who said "wow, I never would have thought of that - but YEAH! That would explain a lot!" Her hearing test came back exceptional, her focus beyond her years, no-one suggested CAPD and we spent many more years saying "I KNOW you can hear me!!!" Until I finally learned about CAPD and had her tested. Yes he can hear beautifully, she can't process what she hears in certain circumstances.

Thank you all. so much.

Laurel- Her hearing was just the normal hearing check by the doctor with the headphones.

She has never had a chance to play with other PG kids. We live of a remote island in a small community and that makes things difficult. She does well playing with one friend at a time in a quiet environment. Definitely. Dh and I are both introverts and I do see that in her. She is just fine being alone.

I am not sure about the name thing either. I need to pay more attention, but it does appear to be more in a group setting I believe. Such as when she went to a camp this summer, she came home never knowing a single child's name even though she was with them for 2 weeks, except those kids she knew form being one on one with them in the past. Girl scouts is a group thing too, and she still doesn't know their names. Sigh.

Thank you all for the book recommendations. I am getting them on my kindle tonight. DD has her one really good friend (age 9) spending the night tonight and she will play and be happy. It is just anytime there are many kids she shuts down and looks confused.

We had a lot of "I know you heard me" in our house too. But now we know that our son really did not process what we were saying. He works with a speech therapist on hearing specific sounds and increases the background noise level each week. This is very helpful.

One thing that I think everyone should do is put on closed captioning on the TV. It will show her how much she is missing through hearing alone. It also retrains the brain to hear more. The Eides book has other helpful things to do too that do not require a speech therapist.

It is great that she has a really good friend! You are lucky:)

Sounds like you can do some more observing and figure out more about friends, names, and hearing from just knowing what to look for.

Keep in mind that for some kids with CAPD, just a small amount of background noise (like a lot of people breathing, paper being shuffled, a fan, a dishwasher, the hum of car driving down the road) can play a big role in hearing. So look for truly quiet environments and compare them to those with any background noise and those that are loud.

Some other books about CAPD:

1. There is a chapter on auditory processing disorders in Eides' book The Mislabeled Child http://www.amazon.com/MISLABELED-CHILD-THE-UNDERSTANDING-LEARNING/dp/B0016IYQV4/ref=pd_sim_sbs_b_17

2. When the Brain Can't Hear : Unraveling the Mystery of Auditory Processing Disorder by Dr. Bellis is a good full book on this topic and explores how it manifests at different ages and in different people, how to test, and how to deal with it.

You are asking questions about when to worry about things you see in your DD. It can be so tricky to distinguish a problem from a PG trait. For questions about social issues, peers, and figuring out when something is normal for a PG kid and when there is a problem to investigate, I'd suggest Misdiagnosis and Dual Diagnoses of Gifted Children and Adults: ADHD, Bipolar, Ocd, Asperger's, Depression, and Other Disorders by Webb et al. http://www.amazon.com/Misdiagnosis-Diagnoses-Gifted-Children-Adults/dp/0910707677 This is a reassuring book to refer to when you have a middle-of-the-night fear:)

This sounds very much like my 9 yo dd who has been diagnosed with dyslexia. She was evaluated on the CELF and her receptive language score was in the 18th or 16th percentile and her other scores were in the normal to above average range. I don't know if the poor receptive language is related to the dyslexia or if it's caused by CAPD. She definitely shows sx of CAPD.

ETA: She has been evaluated 3 times and not once has anybody thought she has ADD or ADHD. But one problem she has, which sounds like CAPD, is that when she is in the classroom she has such a hard time focusing (she even tells us this) b/c of every sound she hears. And it's not like it's distracting her, in fact she concentrates really hard and she can't help but notice these other sounds and it interferes with her hearing what she needs to be listening to. It seems she has very acute hearing.

Her academic performance improves tremendously when she is instructed one on one, and even more so when she is in a quiet environment.

Not to hijack, but I am very interested in this book! Have you read it? DD presents as borderline for a LOT of things but nothing really stands out as THE thing, and a # of things have been ruled out, supposedly. She confounds people regularly.

FWIW DD really seemed suspicious for CAPD from the checklists, although she was certainly missing the academic problems that often come with it.


One other thing I would mention is SPD. DD is very sensitive to loud noises, another CAPD sign, but the diagnostician asked us some questions about it and suggested SPD might be the culprit.

Thanks all. Girl Scouts went okay. DD did seem overwhelmed and sat out a few games. Then during the quiet game mirror mirror she became much more engaged. Then they sang and danced "I say a Boom Chicka Boom" and when everyone got loud and started dancing around DD sat down in the middle of the floor and put her hands over her ears.

Looks like I have a lot of reading to do. I am sure I will be back with questions, but thank you all for giving me some directions to at least look.

DD did tell me that she has a hard time understanding what is said at girl scouts because "everything is just so loud."

Yes x 1,000 to the CAPD.

My DS8 had only a part of it (binaural integration imbalance - which means his brain prefers one ear - but it's almost worse than being deaf in the other ear because the "ignored" ear still receives sound which his brain interprets as white noise that clutters everything up).

Anyway... he is sensitive to noise, totally fine one-on-one, but gets very confused and tunes out in a group environment.

It's diagnosed by an audiologist (about 3 hours), referred from a pediatrician.

The BII that my son has apparently self-resolves by the time they're about 12. I'm hoping...

(Btw, he also has a hard time learning names...)

Thanks yall. DD's friend is still over. They are playing that they are indians and are preparing for winter. LOL. One on One dd is in her element. I am going to be researching CAPD and try to implement somethings and see if that helps since we can't get an evaluation right now.

CAPD definitely sounds like a possibility, amazedmom.

Not to confuse the issue, but just to throw something else out there (that could confuse the issue lol!)... my dd11 used to have the same issues with noises being too loud and not being able to filter out background noises - in kindergarten she couldn't hear her teacher talk because of what she heard as a very noisy classroom (teacher said it wasn't noisy at all). She also was terrified of going into new places - any place she hadn't been before... it seemed to me like it was worse when we were going into crowded public places, large rooms, things like that - so I really thought it was related to hearing in some way and to her sensitivity to noises. She went through listening therapy when she was 5 years old, and that seemed to help.... but ultimately what helped her the most was... vision therapy - she had extreme double vision and lack of peripheral vision as well as difficulty tracking. We had *no clue* about any of that - but in addition to what you wrote about noises/hearing, one other thing sounds very much like my dd at that age - avoiding eye contact. I had to ask her (repeatedly) to look *at* me when I was talking to her and trying to make eye contact. I think there are a lot of different reasons for that avoidance of eye contact, but fwiw for our dd it was because she couldn't see up close and it was too hard to try to focus on our face.

Re remembering names... my ds13 was also like this in early elementary school... still is to a certain degree, but for him, the key was that he just wasn't that interested in remembering anyone's name. He could remember his best friend's name and the names of his sister's best friends, but other kids just weren't that meaningful or interesting to him at that age. That sounds like he had some type of disorder re social relationships - he didn't, he was well-liked and functioned a-ok socially... he just wasn't that interested in other children's names. Once he was in middle school *and* in a much more intellectually stimulating school environment he started remembering the names of the other kids. It's weird, it's quirky, it's whatever. He has no memory issues - he has a really amazing memory. So for him, I think it was all about interest level.

I think it's cute that your dd is playing getting ready for winter - I'm playing pretending it's spring today lol!

Best wishes,

polarbear

Polarbear- I am playing that too. It snowed May 1st,2nd, and 3rd
Not sure when we will have spring. It doesn't usually get green here on the island until almost July. Sigh, last July it was green but snow was still on the ground in places and hiking was quite a challenge. That is interesting about the eyes. I may have DD do a vision screening at the clinic. They have some type of new machine that will alert them to a possible problem and then they refer out. Lots of thinking to do. You know, that is interesting about what you said about your son. DD will remembers names when she has a great interaction with them, for example, she has lots of teenagers who she loves and she remembers all of their names, so it could just be that she's not interested. She does have an amazing memory even if her working memory score wasn't great. She remembers small minute details from years ago. Like, the fact that 3 years ago we ate at an ihop in texas and exactly what she ordered and what the kids menu looked like. It can be frustrating to her at time because I don't remember those types of things. Sometimes I think she takes in so much detail and sound that she can't exactly distinguish between what is important and what's not.

A random idea I had was that if she has unusually acute hearing rather than actual CAPD then musician's earplugs might help her reduce input to a manageable level. My husband has a 50% pair that he wears when needed. I can't imagine you could get those on your island though. They are custom made to your ear.

Ultramarina I am trying to find a moment to send you a PM, but I bought that book on kindle a year or so ago, read the whole thing and found it really useful. And as that sort of text goes I found it more readable than say Different Minds by Diedre Lovecky

Further earplug thought - you could trial this with foam earplugs, the psychologist we saw re Aspergers recommends cutting foam earplugs in half and wearing them as needed to reduce auditory stress. Cut in half they'll reduce noise but not be completely effective. And they're cheap and should be readily available.

Just to throw in here, it's possible I have CAPD, too. I fit all of the original description. I also have poorly corrected vision problem, amblyopia. However, I think of mine as being all on or in cruise mode. When I interact with people, I am 100% engaged, I am over aware of individual nuances and social mores to the degree I am uncomfortable interacting in a group until I know the people because I am far concerned with offending than minor gains an introvert might take away from an interaction.

Aaaand more CAPD impact - not sure if this will sound familiar:

Here's the email I sent to DS8's teacher today...

Hi!

DS8 and I were practicing his spelling words and I noticed that he really can't tell the difference between the "v" sound and the "th" sound (ie trustworthy vs. lovely). I'm assuming this is related to his auditory processing issue.

(On a positive note, he spelled "sweet" as "suitt" which is similar to "je suis" so it looks like the French phonics are sinking in )

Anyway, re: "v" and "th" ...the only way he could tell them apart was by watching my mouth as I said them, and this was only after I explained the teeth position for each sound (on the tongue vs on the bottom lip). I told him to watch your face during the test. I don't know if he'll remember, or if you can remember to face him while you're saying the words? ...but I just thought I'd mention it anyway (re: more understanding of his challenges).

Thanks

(CCN)

On the earplug subject...

This might be too effective, but when I wore earplugs for swimming, the best product (and cheapest) was Silly Putty. Custom molds to the ear and much cheaper than doctor made custom ear plugs. Just make sure that you use a large enough lump of Silly Putty (using 1/2 of the "egg" in each ear always worked well for me).

CCN, that story about teaching your son the difference between sounds by showing your face does sound familiar! This kind of explicit teaching can be so effective.

We have also found that, once each sound is learned, we can spell words to clarify the proper pronunciation.

The University of Iowa has a website that provides both video and cutaway animation video of the pronunciation of each phonogram. These can really help teach a kid to see how to pronounce and see the movements of the different sounds. http://www.uiowa.edu/~acadtech/phonetics/

"DS8 and I were practicing his spelling words and I noticed that he really can't tell the difference between the "v" sound and the "th" sound (ie trustworthy vs. lovely). I'm assuming this is related to his auditory processing issue."

Yes, this can be part of CAPD or auditory processing deficits. One of the subtests my child scored very low, the write-up mentions this, although, I think they mention /f/ instead of /v/. Those two sounds are also very close, though.