Gifted Issues Discussion homepage Forums Twice Exceptional Dealing with ADHD, ODD and PG

My DD is 8.5yrs old, she has a GAI of 156 (170 with extended norms). Her WISC testing showed that there were 4 sds between her VCI/PRI and her PSI scores. She was also tested with the WIAT, this was 18 months ago so a little outdated, most of her scores were around the 130 except for a 160 in maths. The Ed Psych said she was severely underperforming given her IQ scores.

We then saw a different consultant who diagnosed ADHD, plus Oppositional Defiance Disorder. She now takes medication for the ADHD which lasts her through the day at school. She also has huge anxiety issues that seem to impact on her, we are waiting to see a Paediatrician about this and get her some help for the anxiety. However, she is coasting along in school but doesn�t seem to want to push herself or let the school know what is going on inside her head. She doesn�t care for anything except Minecraft and her cats. We�ve channelled her into sport which she is loving, but she doesn�t care at all about school work, though she loves the school. We�ve never pushed her academically, but do wonder, just what she holding back.

Does anyone else have a PG kid with ADHD and/or ODD. Do they have a lack of motivation? How do you deal with a child with anxiety levels through the roof, yet with all the hyperness (compressed during the day) of ADHD and the stubborn-ness of the ODD. I struggle with her ODD more than the ADHD, though the meds really help with both. The time before the meds and the time when they have worn of are very hard on all of us. Any advice or tips on bringing up a child with a lot of letters after her name. Many thanks.

That combination -- ADHD, ODD, anxiety-- is also often seen in autism spectrum disorders. We found with our DS (now 11, Asperger's/autism) that he was oppositional/defiant or just tuned out when asked to do something that didn't interest him-- he saw no reason to comply. He is still far better motivated as a self-driven learner than as a school learner, but this has improved with ABA therapy.

On the meds issue: DS11 gets a long-acting ADHD med in the morning, but needs a short-acting booster dose in the afternoon to hold him together till evening. This makes activities possible, and makes our lives more pleasant.

HTH
DeeDee

What med is she on? I can't answer to the PG gifted part (DD has never had an IQ test) but she does have pretty severe ADHD. We put her on meds about 1.5 years ago when she was 6 and have had to do a lot of experimenting to get it right. Concerta and Adderall both seemed to wear off early in the day and she would get very moody when they wore off. Adderall in particular seemed to make her quite hypersensitive and somewhat anxious. We were dealing with crying and tantrums and debates on a daily basis. She would argue about everything we said like a surly teenager (she is 7). If she didn't have ODD before, she did on Adderall (I say that tongue in cheek)! One thing you can do in the evening is add something short-acting to get her through til bedtime. What we found finally works for DD is the Daytrana Patch. She also takes Ritalin in the morning to work til the patch kicks in (it takes a couple hours). The patch can be worn for 9 hours and it wears off very gradually so she is focused until about 7-8 in the evening and doesn't get moody. Your DD may be very different, but if you feel like the ADHD is still giving her issues, don't give up on the meds. There are so many meds and combinations that can be tried.
Oh yeah, I should add that she struggles with motivation when she is not medicated properly (for instance too low of a dose or before or after it kicks in). When she can focus, she is very motivated. Not sure if that helps. I hear you on Minecraft--it is quite the obsession here as well, with both kids.

Hi,
As DeeDee mentioned, sometimes similar things are seen but different diagnoses are given. I think DeeDee's DS and our DD/DYS10 have similar issues, so that's been interesting. Our DD is I think EG rather than PG, but she was also suggested to have ADHD, ODD, Asperger's, and dysgraphia a couple of years ago. Fortunately she does not seem to have much anxiety. The thing was, the psychologist who suggested all of these diagnoses was associated with the school and the diagnoses were suggested on the basis of questionnaires filled out by the teacher who couldn't stand DD...so after much research and consulting a specialist in 2e kids (an 8-hour drive away), I think what DD actually 'has' is some level of ASD (possibly even 'social interaction disorder' or whatever it's called in the new DSM) and some dysgraphia. Apparently ASD can look like ADHD, especially now that there are so many 'types' of ADHD (e.g., 'inattentive'). Not that some people don't have 3 different disorders (or more), but it's more likely that a person has one disorder than 3, especially if the symptoms overlap. In our DD's case, the apparent ODD stemmed from the authoritarian teacher--DD responds very well to clear rules, reminders (preferably only one!), and prompt consequences. Unclear rules, uneven enforcement, and/or seemingly arbitrary and inconsistent consequences provoke a strong negative reaction. Fortunately we have generally had wonderful teachers who provide clear rules, etc., to all the kids, so for now things are going well. And of course at home it's a matter of routine for us now to remind and then give consequences; we just need to do it every time or she will totally game the system.

Anyway, sorry to ramble--the point I'm trying to get around to is that it can be complicated to figure out, and I highly recommend that you see a specialist in 2e kids if you can. Also, if you haven't seen it yet, the James Webb Misdiagnosis...of Gifted Kids, available on Amazon
http://www.amazon.com/Misdiagnosis-Diagnoses-Gifted-Children-Adults/dp/0910707677

I guess some people on this board have seen the Amends, and one of them is a coauthor, so that might be something to explore.

Finally, I also should say that our DD is also unmotivated, and we have not found a solution for that, except that she loves dessert and video games, so we have devised a very complicated reward structure that works pretty well for us. I would very much have preferred to not use dessert, but sometimes you have to use the tools you are given.

Best of luck!

I would third, especially in a girl, considering the possibility that ASD might be at play.

DS9 could have probably been labeled ODD before he got treatment (meds & therapy) for his PDD-NOS (and ADHD & anxiety.)

We got him on Risperdone (the only medication approved for treatment of ASDs, btw) and Intuniv (non-stimulent ADHD med - ASD kids often have problems with stimulents) and he is like a different child. That along with therapy and a better school situation has been like magic for him.

I strongly recommend an eval by a neuropsychologist. Also, stimulents can make anxiety worse, so you might want to look at trying a non-stimulent med for the ADHD. There are several available now.