Gifted Issues Discussion homepage Forums Twice Exceptional If not ADHD, what?

Hi everyone. I posted here this summer about my son, and I feel bad about not being a good, supportive board member (tbh I have horrible social anxiety that sometimes even extends to online ). I really need some advice or insight or something, though. I'll apologize in advance because this is going to be very long. If you actually get through it--thank you!

My ds9 has had a GAD diagnosis for a couple years now and was diagnosed in June with ADHD, along with a provisional diagnosis of Tourette's, by a psychologist (not experienced with gifted). Working with his pediatrician, we have been trying to find a medication that will work for him. We have tried Ritalin, Adderall, and Concerta so far and have seen NO improvement at all. His ped is concerned because she says that when the diagnosis is correct you almost always see quite a difference. She is questioning the diagnosis.

He has so much trouble focusing and gets distracted by any little thing (external or internal). He has a really hard time transitioning and at home I feel like I'm constantly telling him to either start doing something or to keep doing something. Talking with him can be very frustrating because he keeps stopping. At home sometimes it seems like he can't be serious about anything; he's always messing around being silly when he should be doing other things. He takes a long time to do homework, even things that are easy for him. Actually, he takes a long time doing everything-- getting dressed, eating, getting out of the car when we get to our destination (he's usually reading), etc. He seems really immature one minute, and really mature the next.

He has a very poor working memory--every night he has to read for 20 minutes and write a 3 sentence summary, but every time he has to actually look back in the book to do his summary because he can't remember what he read. He was also just diagnosed with an expressive language disorder by a private SLP.

Some background:
He was pretty advanced as a toddler and preschooler--taught himself to read at 2, writing words by 2 and sentences by 3, adding and subtracting at 3, deep philosophical questions at 4, taught himself multiplication at 5. Always very mature, never even had to use any discipline techniques except for explaining why he had to or could not do something. He went to full day, 3 day/week play-based preschool and never had any behavior problems at all there, either.

We started seeing some issues with still having emotional outbursts/mini tantrums in kindergarten and 1st grade, but no attention issues in school. He did go to a martial arts class where he goofed off quite a bit when he wasn't actively doing something. I pulled him out of school halfway through 1st and homeschooled him (he was not learning anything). It was during this time that I noticed he was extremely resistant to doing any work he didn't want to do and therefore couldn't focus on it. Admittedly, I was not very confident in my ability to homeschool and didn't really know what I was doing, so made it pretty much school-at-home. We homeschooled for about a year, but then he had to go back to the same school.

When he went back they put him on a behavior plan because he was still having a hard time controlling his emotions. As he matured, he stopped having the outbursts, but all this time he was having a harder and harder time paying attention at school and at home (when he's not doing something of his choosing). In 3rd grade he started having huge writing issues (went many writing periods not getting a single sentence down) and this is STILL happening. The school is really dragging its feet on evaluating him, but I think they might finally do it soon.

He has taken outside classes and all day camps of his choosing, and had no issues at all. In fact, in some, he commented on how he was the only one not goofing off at times and taking the learning seriously.

Test scores from evaluation in June:
SB5 results:
Fluid Reasoning 138
Knowledge 117
Quantitative Reasoning 133
Visual Spatial Processing 137
Working Memory 106
FSIQ 130

NEPSY II:
Animal sort total 17
List memory 10
Auditory attention total 11
Auditory attention combined 10
Response set total 10
Response set combined 6
Word list repetition 12

Word generation semantic 5
Word generation letter 11
Inhibition naming combined 12
Inhibition inhibit combined 15
Inhibition Switch combined 16
Clocks 14
Word list recall 16

He also had the Beery VMI 2 years ago:
Visual Perception 142, 99.4
Visual Motor Integration 99, 47
Motor Coordination 97, 42

Does anyone know what the possibilities are other than ADHD? I'm so tired and confused and just don't know what to do about him. Again, I'm so sorry this is so long. Thanks in advance if anyone gets this far.

sciencelover, what type of professional did the evaluation in June? It looks like you have the typical suite of tests that might be included in a neuropsych eval - was it a pediatric neuropsychologist?

The one thing that I see in the tests from June is that there is possibly a fine motor challenge (evidenced in the discrepancies in the Beery subtests). Your ds' working memory and knowledge categories are also quite a bit lower than his other scores on the SB-V. I am not really familiar with the SB-V so don't know which type of subtests specifically go into which category, but it might be useful to post actual subtest scores here, not just the categories. When you see deviations greater than 1.5 SD (1 SD = 15-16 points on the SB-V, I'm not sure exactly which) it *might* be indicative of either an LD or some type of other challenge. If there is one subtest that is timed and relies on fine motor skills, it would be interesting (and possibly informative) to see if it has a relatively low score.

The "Knowledge" category on the SB-V is also low relative to the othe

The "response set combined" on the NEPSY is also very low relative to his other scores. I don't remember what that subtest measures, but you could google for an explanation of it and try to see how it fits in with what you know and have observed with your ds.

Re what other possibilities - chances are there are quite a few other possibilities. Symptoms and behaviors that are reactions to challenges can overlap between quite a large number of challenges. Some of what you've written above sounds very much like my ds who is dyspraxic and dysgraphic and also has an expressive language disorder. He was also given a diagnosis of ADHD when he was young yet the ADHD "symptoms" disappeared when we discovered he was dysgraphic and had appropriate classroom accommodations in place. I wouldn't make the leap to dyspraxia right away though - these same symptoms could be caused by many different things. FWIW, I had heard the same thing about ADHD meds that you've been told - if you try them and you *don't* notice a difference, that means it most likely isn't ADHD. I don't know how true that is, but that is what we were told by our ped for our dd who was suspected of having ADHD.


Are you sure the things you think should be easy for him really *are* easy for him? I also thought this about my ds in first grade - he was refusing to do math worksheets that were sent home for homework. They were *easy* and he's really good at math. I knew he knew how to do the math. What I didn't know was that he couldn't *write* and that writing was painful for him. It wasn't the math that was the challenge, it was the writing. Deconstructing all the steps in any one given assignment might help understand why he's refusing to do the work. Also look for patterns in what he refuses to do. Our ds sometimes could sit down and complete a writing assignment, sometimes couldn't (more often couldn't). When we looked (over time) at the assignments he was struggling with vs what he could actually get started on and work through - it was the open-ended writing assignments that were difficult (actually impossible in early elementary). Those related back to his expressive language disorder, but it wasn't until he was around 9 years old and finally figured out how to tell us (parents) that he just didn't know what to say that we realized what was happening with writing wasn't *just* about writing, it was a larger issue with expressive language, which is where working with an SLP helped tremendously.

I am going to be back in a few minutes with some more thoughts - need to run at the moment.

Best wishes,

polarbear

Some other possibilities that fit the symptoms that you're seeing--
anxiety
sensory processing disorder(s)-- leading to distractibility
asynchrony of some other non-specified type (?)


I guess given that you HAVE seen settings where he did not appear to have ADHD (camps, etc) and that medication trials didn't help-- I'd lean toward assuming that ADHD is not what is going on.

I'd strongly recommend finding a psychiatrist to work with on the meds. They are far more experienced than a pediatrician.

I'm actually a little surprised they started him on stimulant meds, given that they think he might have tourette's (stimulants can cause or worsen tics). I would think they'd try some of the non-stimulant ADHD meds first.

Thanks so much for the replies.

Polarbear, in response to your question, it was a psychologist who evaluated him in June. She has a good reputation, but her expertise is developmental disabilities (autism specifically) and she just doesn't have much experience with gifted or 2e kids. Unfortunately our insurance limits us quite a bit on where we can go and she is the only psychologist at the center we were referred to. If this next dosage of medication doesn't work the ped might refer us to the big university hospital, where it would take forever to get an appointment, or just send us back to this same psychologist.

I'm not sure what the subtest scores are. The only other information on the SB5 section of the report is:

fluid reasoning: verbal 19 nonverbal 14
knowledge: verbal 12 nonverbal 14
quantitative reasoning: verbal 15 nonverbal 17
visual spatial processing: verbal 17 nonverbal 16
working memory: verbal 10 nonverbal 12

He has said that his trouble with writing is just coming up with what to write. This year he has been allowed to use the computer to do all of his writing and it hasn't made a difference. He did do very well on his last book report, but that was with me sitting there with him, asking him questions for each section. Without the questions to let him know what to say he would just sit there. I really don't think there is a handwriting issue with math. I got permission to substitute part of his homework with Art of Problem solving that he's doing at home, and he has way less trouble getting started and staying on task with that, even though there's more writing (copying the problems from the book). However, there could be underlying OCD issues involved. He hasn't been diagnosed, but he definitely has many of the traits and I know it goes along with Tourette's a lot of times. The problem is that it seems like every professional that I've talked with only wants to look for a specific thing. For example, the psychologist in June only ever considered (and administered the subtests of the NEPSY which could show) whether or not he has ADHD, not whether it could be other things.

I actually got him evaluated by a SLP because of your recommendation back in August and she did the CELF, but didn't put the scores into any kind of context in the report. She did say that he has an expressive language disorder and he'll be getting speech therapy.

HowlerKarma, I am seeing a lot of regular anxiety symptoms along with more and more obsessive compulsive type stuff lately. Every professional kind of dismisses the notion that ADHD type symptoms might be anxiety or even sensory related. He had an OT evaluation 2 years ago and she said he had some sensory issues, but was pretty vague and didn't feel like he needed therapy.

Epoh, I will try to find a psychiatrist who will take our insurance. When he tried Aderall it really increased his tics (which are pretty mild normally), so we stopped it. I will ask the doctor about non-stimulants at our next check-in.

Again, thanks for replying. I appreciate it so much.

Hi Sciencelover. I am not sure I can help you with much but what struck me is that your DS had an almost identical SB V to my DD when she was tested at 7. When she was tested the psychologist turned out to be not familiar with giftedness and took three hours to administer the test, so they probably weren't that familiar with the SB V either. We had requested the SB as it has less reliance on timed elements.
DD was comparatively low on working memory, same scores as your son, and knowledge 11 and 14. She also had the same pattern of strengths. I did some research and the working memory is typically 'low' although in the normal range for gifted kids on the SB V. The psychologist can compute the gifted composite score which excludes working memory.
Our DD was retested at 9 with a tester familiar with giftedness and the SB V and the pattern was the same but the scores were much high, except fluid reasoning which she hit the ceiling on first time. Working memory had improved but was still lower than everything else.
I put low knowledge down to the fact that she was under challenged and so knowledge wasn't where her potential indicated it might be if she fully engaged with learning.
Now with DD we are discovering a few different things. She has hypermobility, probable EDS, which makes writing painful. She has always struggled with writing and is having physio for her generally poor muscle strength and joint problems (multiple dislocations in the last few months). The hypermobility is exacerbated by growth spurts and impending puberty.
The second psychologist emphasized that the strong visual spatial/fluid reasoning profile goes with visual learners who can struggle in audio sequential dominant classrooms and they are often unrecognized for their giftedness. This is becoming more obvious in high school. DD is a slow reader, despite reading very early like your DS. She has to turn the words into pictures in her head and that takes time. The reading load is increasing in high school and making life tougher. Her eyes also tire easily due to the EDS and weak eye muscle control.
DD works a lot better on things she is interested in because it all takes a huge amount of effort, it is hard to direct limited energy sources to things you don't care about. However, it is important for us that DD try at all things to learn as much as she can.
DD is very sensitive and if we didn't acknowledge her easy fatigue, need to be fed and watered regularly and make efforts to adapt to her different needs then I can imagine she would have emotional outbursts too. We have been lucky that she has her fathers even temper.
Not sure what else is going on with your son but have a look at visual spatial learners just in case. Linda Silverman is the guru. Lots of info on the Internet. Check her Gifted Development Centre website. Her book is Upside Down Brilliance. We are having DD assessed with an educational specialist experienced in visual spatial learning on Monday.
We are finding that there isn't one simple answer for anything but we are managing most things.
Good luck. Hope you find what you need. Sending support. I totally get the social anxiety bit!

Just one other thing: The comment about writing, difficulty coming up with what to write, is something Linda Silverman talks about. Kids who see in pictures can have huge difficulties turning their ideas into words. There are so many skills involved in writing, not just the physical act, but all the mental processes of translating ideas into words, that strongly visual dependent kids can be overwhelmed and not able to get started. Add timed situations into that and anxiety becomes a huge issue.
Not everyone believes in different learning styles but I have seen their impact. It's worth adding it to your list of possibilities.

He sounds very much like my DS9 - dx ADHD combined type w/expressive and receptive language processing disorder (although on one of his CLEF categories he scored age-equivalent 5 yrs ahead... go figure).

Anyway, I've always suspected he has a sensory integration issue, and that's the first thing that comes to mind when I read about your DS. Sensory issues can wreak havoc. We've been through countless sensory behaviors and tried every fidget/chew/etc product out there it seems. (Thankfully he no longer eats his pencils, lol). His current quirk is ripping paper "I rip the paper so I can think." I've resorted to covering his duo-tangs with packing tape so that he can't rip them, but he still rips his lined paper and worksheets.

I am also surprised that you were given stimulants for him... my ped specifically warned against them (my DS has also had tics). She suggested that if we try meds we start with Strattera (atomexetine - I think? - a non-stimulant).

Re your comment: "The problem is that it seems like every professional that I've talked with only wants to look for a specific thing." ...ditto!!! Omgosh... isn't it frustrating.

Anyway, best of luck

I thought for an ADHD diagnosis the behavoir had to be apparent in all situations? Sorry can't help unless he has just checked out?

Ndw and CCN thank you for the replies. Ndw, I was surprised his knowledge score was so low, but what you said about your daughter scoring lower because of not being challenged makes me think that is probably true for him. I will definitely look into visual spatial learners. I’ve always known he’s a very visual person, but didn’t realize how much it could affect his life. He is also really sensitive—he can pick up even the slightest hint of sadness or worry in my voice, can’t handle listening to certain music because it makes him too sad, has started crying when something on tv was sad (when he was in preschool the big one was when Steve on Blue’s Clues was wondering why he never found the clues).

CCN, that’s interesting that there was such a gap in some of your son’s CELF categories. Did the tester test all the categories? Our report has all of them listed, but many weren’t tested. I don’t know why. My son likes to rip paper, too! Actually (this sounds so weird) he has ended up eating some bookmarks because he will hold them while reading, rip them into little pieces , and put them in his mouth. We try to make sure he always has gum. I know he needs to get more exercise but right now I just don’t know how to do that when he spends all daylight hours either at school or doing homework (he can’t do it later after playing or he won’t have enough time).

I will definitely ask the doctor about non-stimulant meds.

Most important thing is to take a deep breath and know you aren't alone. No two kids are the same but with all the people on here elements of your experience will resonate with others, they do with me. DD used to be impossible in the mornings before school, doing anything but getting ready. Now she is older she is better. She has worked out how long it takes to get ready and won't start dressing or doing teeth until that time!!
I was thinking about the Tourette's diagnosis. When DD was having a particularly bad year at school she had some interesting repetitive behaviours, mouth movements like yawning, chewing hair etc that went away when the anxiety was removed by going to a full time GT class. Sensitive kids do odd things. Of course he may well have Tourette's but anxiety will certainly exacerbate tics.
Is he being challenged at school?? We discovered DD was more gifted than her initial SB V indicated when she was retested but also when she was eventually challenged appropriately she took off! When not challenged she has presented with anxiety and depressive symptoms.
For exercise a trampoline was the best buy we ever made. She jumped for hours.
Let you know how the visual spatial testing goes.

Have you taken a look more closely at the classes and courses you said he excels at? What is different in those vs. his school? Also what is the structure like at classes/camp vs. school? I was talking to one tester when we were struggling with one school and she was telling me that a certain subset of gifted learners actually can not learn, and truly suffer, in a more open environment like Montessori b/c without the structure they can't find their bearings of where to stop, focus, start learning etc. Just a thought, but sometimes you have to "flip" the problem to see what works and why, and then deconstruct what doesn't.

Only thing that I wondered reading your post is whether you are trying a high enough dose of meds. We didn't see any effect either with lower doses. With Daytrana, we had to go to the highest dose possible (30 mg)--the 10 and 20's didn't make any obvious difference. If you've gone up to a high enough dose, then it seems strange that the meds don't help at all if it's really ADHD. You could try some non-stimulants and see if they do anything before giving up. There is a book by Amen "Healing ADD" about ADHD and the different types and how stimulants can actually make some forms of ADHD worse. It also suggests some over the counter options and other alternatives.

This was always my understanding... it has to be consistent across multiple settings(and it's not the case with my DS. I'm not entirely convinced he doesn't have ADHD, but I think it's mild and exacerbated by sensory issues).

I'm not sure if all of the CLEF categories were tested... there were 6-8 scores if I recall. He was only ahead in one category (basically normal in the rest), but ahead by 5:3 years. The SLP said "yeah... on paper it's hard to see that he needs help." lol.

To further put this into context, two years ago, in a related area (expressive language) on his psycho-ed assessment he scored in the 10th percentile (for receptive it was even worse: 0.5th percentile). The psychologist at the time said she thought that his ADHD was impacting the test scores, so when I saw the CLEF results I was relieved. She recommended that we medicate him (haven't yet) and get another psycho-ed assessment in a couple of years to try and pin down his scores (haven't yet and likely won't).

Speaking of paper... gosh I wish he'd quit ripping it!! His books are a mess.

My son LOVES gum too He's not allowed to have it at school, but I bought him chewable pencil toppers:

http://www.nationalautismresources.com/cheweze.html

...which were fabulous when he needed them. He's stopped chewing now and moved on to paper ripping.

Btw - his sensory issues (which have gotten milder) were so bad that the school was convinced he had autism, which we've since ruled out.

Re: gum - he also takes it out of his mouth and plays with it (cringe) and blows massive bubbles that get stuck on his face. We have a new rule that if there is any gum left that he can't get off, he loses his gum chewing privileges for a week. LOL it works... he's really careful now

Re: exercise: my son could use more too. Sometimes if he's wiggly during home work I have him take a "running break" where I get him to race up and down the hallway as fast as he can. He loves it. I yell "go! go! faster! faster! c'mon!" and he laughs as he runs.

Ndw, it actually does seem like he has Tourette’s. Before the evaluation, I noticed the humming, blinking, and throat clearing that he did but it just didn’t even enter my mind. The more I’ve been reading up on it, though, it really does sound like him (those were his first tics, the ones the tester noticed, but now he has different ones). But, I do have no doubt that his anxiety, which has been much worse lately, exacerbates them.

Sadly, he is not and has never been challenged intellectually in school. I don’t count writing as being challenged, because it is obvious to me there is something going on there. I have been trying to work with the school since kindergarten (minus the year of homeschooling) to get him what he needs. It has gotten a tiny bit better because now his math teacher lets him work on a higher level packet during class (but doesn’t give him instruction) and lets him do Art of Problem Solving instead of most of his homework. So, while I hate to complain about this, he’s still not getting what he needs in school because he’s either just working on his own without the teacher, or having to fit in the AOPS after a full day and other homework. He says he is happy and likes school, but I’m concerned because the anxiety makes him very resistant to change, even good change.

I would love to get a big trampoline, but we have no yard.:( We do have a small indoor one; I need to think of ways to make it fun to jump on it for a significant amount of time.

Mykids, that’s interesting. I do feel like my son definitely needs a structured environment to learn best. Even at home, he has a really hard time figuring out what to do in his free time (unless of course he’s allowed to use the computer). I always just assumed school was nicely structured. The classes and camps he’s done have all been chosen by him, so the topics were ones he’s interested in. Even if they weren’t very academically challenging, they included a lot of fun elements (art, structured play in nature, science) and no written output required. He was allowed to register for a chemistry class for 7th and 8th graders (he’s in 4th) for the week of Christmas, and I don’t think he’ll have any issues.

Thank you everyone for your thoughtful responses.

Hi sciencelover. We just got back from assessment with the educational specialist for my DDs visual spatial learning. We will get the report in a few days. The specialist talked to DD a lot about visual spatial learning. One thing she recommended was learning to touch type to help overcome both the physical difficulties of writing, but also the mental challenges of getting started with writing. The following site is free and is for kids.

http://www.bbc.co.uk/schools/typing/

She told DD that when she can't think what to write to just download her thoughts by typing. I have seen a suggestion where kids type with the screen off or covered so they can't see what they are typing. It lets them write freely without getting caught up in typing errors or self editing. Thought that might be something to try with your DS.

The specialist also talked about the value of mind mapping. There is an app for mind maps. Look at www.inspiration.com

For exercise, DD has a fit ball for physio. There are a lot of exercises you can do with it that strengthen the core muscles and can be surprisingly tiring while kids stil feel they are having fun.
If we get any other tips that might be worth a try I will pass them on.
Hope you are finding a way forward.

Hi sciencelover - I registered so I could respond to your message, because your son sounds so similar to ours. (I also have social anxiety, so I'll probably worry about this message for a few days!)

Ours is not quite as advanced, but he taught himself to write at age 3, to add and subtract 2-digit numbers, and to read chapter books before kindergarten. He has sensory issues, like not liking lotion or to brush his teeth, lying down all the time, and poor handwriting. He is a happy person, but has a low frustration tolerance and can't modulate his emotions.

We did a round of testing and the first diagnosis was ADHD. The psychiatrist we went to recognized that other things were going on too, but recommended treating the ADHD first, because it will make other services more successful if he can pay attention.

We tried Ritalin, Concerta, Metadate and Adderall in a variety of doses. No positive impact, just side effects. I find it hard to get people to believe me.

We tried Tenex, which is a blood pressure medication used off-label for ADHD. Nothing good happened. He was tired, irritable, and at a higher dose got a very bad headache. No positive impact.

We tried Zoloft, with the idea that it would reduce anxiety or OCD tendencies and smooth out negative emotions, so maybe he wouldn't react so strongly to everything. It worked for that, but his impulsivity was worse and became more obvious, because he didn't care as much about consequences.

At this point, the psychiatrist is leaning toward saying he is on the autism spectrum or has a social communication disorder with ADHD. (My son looks people in the eye and has some friends, but his stories do not make much sense and you have to ask him questions.) I get frustrated too with how doctors and therapists focus on one thing like ADHD and see everything through that prism, but I can also see now that they have to make it fit in certain boxes to get insurance coverage and services at the school.

It appears from articles on the internet that kids on the autism spectrum with ADHD tend not to respond reliably or predictably to ADHD medication. Perhaps kids with other issues, like expressive language disorder and ADHD, don't respond to the typical ADHD medications as well.

Our son is going to get a full evaluation at his school next month. I am hoping they will diagnose an expressive language disorder qualifying him for speech and language services, OT for his sensory issues, and maybe even a behavior intervention person to help him learn how to respond appropriately in the moment.

The next medication that we can try is an anti-psychotic, Abilify, which I understand is approved at a low-level dose for autism and is being prescribed off-label for kids with ADHD who don't respond to the typical ADHD medications. Like all the medications, it has serious side effects to consider. I think Abilify is used to control tics as well, or something in this category of medications is. The psychiatrist said Abilify has fewer negative side effects than Risperdal and the others. As I understand it, the mechanism is sort-of the opposite of the stimulant medications. Also, I think it's one where we should know pretty quickly if it helps.

Anyway, I mostly wanted to say that I sympathize. Our psychiatrist said that she would have recommended the stimulant medications first even if his other issues had been more clear, because they are the most benign of the medications that kids try for these issues - the kids respond quickly (or not) and the medication is in and out of their systems quickly, and if it works, the other treatments progress more quickly and effectively. At least now I don't have to worry about him ever abusing stimulants!

Thank you very much, ndw. I didn't realize how helpful typing could be even if the biggest challenge isn't the physical act of writing. I have not been prioritizing it, but will start. We have used that bbc typing site a little already, and I'll make sure he does a bit every day. I'll also take a look at Inspiration. Thanks again!

Thanks for the commiseration, hardtochoose. It is so frustrating to not know what's going on with your kid. Before he was evaluated, my brother and one counselor had suggested that maybe he has Asperger's, but I never thought he did. The testing psychologist confirmed my instinct by telling me that he is definitely not on the spectrum (she has worked with autistic people for 25 years and also evaluated my younger son, who DOES have autism).

That is great that the school is going to give your son a full evaluation. We usually just find more frustration when dealing with our school. I asked about evaluating him last year (because of his writing issues), and they never did. Then, I thought they might be more willing to do it this year since he has the ADHD diagnosis, but nope. I guess they are doing RTI, but frankly it sucks for us. They put him on a behavior plan for 6 full weeks of school (not counting partial weeks) to determine if the writing thing is a behavior issue or skills issue, then after winter break they will start him in a small group intervention thing and then finally after 6 weeks of that they'll decide whether or not they will evaluate. If they decide to do it, it will be almost the end of the school year by the time it happens. I REALLY wish I could afford private educational testing, or a neuropsychological evaluation or something that might finally give me some accurate answers.

I do have good news--we finally got an appointment at a different place for an OT evaluation. It's the same place he just recently had his speech eval, and I'm hoping they have plenty of experience with sensory issues. It's not for another month, but at least we're not still on the wait list.

My son has been taking Zoloft for a couple years and I was actually thinking that we need to increase his dose, as he has been have a lot more anxiety. I didn't realize increased impulsivity could be one of the side effects. Now I know to watch out for it if we do increase the dose.

Thanks again for the reply, and sorry this is so rambling and disjointed. I'm running on little sleep today.

Hi sciencelover. Just wondering how you were progressing. I don't have a lot more to add from the assessment we had. The report was disappointing really. The best suggestions I have already given you. I was intrigued that the process was used as a screening tool for ADHD, autism spectrum, sensory processing disorder and so on, based solely on an online questionnaire we filled in prior to the appointment. That was then used to suggest a whole range of courses that might assist learning. I was by then very dubious about what we were involved with. I asked the tester how her observations matched up with the ' diagnostic questionnaire ' and there was no real response.
I will keep reading and researching to help my DD. I'm reading The Sensory Child Gets Organised by Carolyn Dalgliesh. It has some interesting tips from an organizational specialist. The subtitle is Proven Systems for Rigid, Anxious or Distracted Kids. I would be curious to know if it holds anything of value to you or hardtochoose.
The other book I found interesting is Misdiagnosis and Dual Diagnosis of Gifted Children and Adults. There is so much overlap in the symptomatology of various disorders and giftedness. It all can be quite confusing and overwhelming.

Thanks for checking in, ndw. I'm sorry to hear your assessment wasn't very informative. We have not really gotten anywhere yet, but do have some things in the works. At school, they are putting him into a small group with interventions for writing. After six weeks of this, they will decide whether or not to evaluate. This is extremely frustrating since I first brought up my concerns last year in third grade, and if he even does get evaluated it will be towards the end of fourth. He has an OT evaluation at a new place scheduled for this month, and they are having me fill out a sensory profile for that, so I am optimistic that they will figure out his sensory issues and what goes along with them.

I have been communicating a lot with his pediatrician, and she seems pretty confused. She says she is really doubting the diagnosis, but is hesitant to send us back to the psychologist since the evaluation was only done back in June. So, she has prescribed yet another medication, but it seems like she is quite doubtful it will work any better. I am holding off on starting it, because she told us we could up the dosage on his anxiety meds and I want to see if that has any significant effect first.

Thanks for the book recommendations (I have actually started Misdiagnosis and Dual Diagnosis of Gifted Children and Adults before, but haven't finished it), I put a hold on them at the library and will let you know if they were useful for us.

I hear your frustration. It can be so hard waiting for assessments and plans to be put in place. Other people don't have the same sense of urgency about the problems we as parents do.

Your paediatrician sounds sensible. Hopefully the increased dose of the anti anxiety meds will help. How was your son over Christmas break? Did time away from school help?

The OT assessment will be interesting. Heightened sensory awareness and anxiety feed off each other.....something is irritating, you get worked up, everything becomes irritating! I get that. Best thing we bought DD...noise canceling headphones. They provide a quiet retreat wherever she is.

Here's to a better year in 2014