Gifted Issues Discussion homepage Forums Twice Exceptional What to expect with ADD?

I want to get DD5 evaluated soon for ADD. She's fits into almost every check list that I've seen for ADD (although, she also fits into many for SPD too so I'm not sure there...). I really don't think it's a boredom issue either because it occurs at home and her previous teachers have said many times that she had a hard time concentrating even on activities that were challenging for her at an appropriate level (her last school was a Montessori school and they did make a point to work at her pace).

I've read that many gifted children tend to hide it and that just doesn't ring true for her. She's very disorganized, gets distracted almost immediately, when she's hyperfocused you almost have to scream at her to get her attention, poor handwriting, constantly touching things, constant talking/interrupting, extremely picky with clothes, forgetful, stubborn etc.

I'm mostly looking for resources, other parent's experiences, questions to ask her teacher etc.

I have wondered for a couple of years about ADHD with regard to DS6. But, some prominent experts in the field of gifted education are of the perspective that overexcitabilities and asynchronous development can account for ADD-type behaviors. They caution that there is overdiagnosis of ADD (http://www.sengifted.org/programs/seng-misdiagnosis-initiative)

What we are doing now is getting a full neuropsych eval (per advice I got on this forum) with experienced testers knowledgable about gifted traits. It will cost a significant amount of money, but at least I'll finally have an answer that I can rely upon, and hopefully some information on how to help my son with the issues, regardless of cause.

Good luck to you - I hope you find what you're looking for.

Is there a school psych? You could ask if she/he can do an observation to see what percentage of time she is on task. I'm not sure what is normal for a 5 year old (kindergarten?). I was told that for first grade they should be on-task 80 percent of the time. There are also inventories for ADHD (like Conners) that you can fill out as well as teacher versions. They can't diagnose ADHD but you can take the results to her doctor.

Ask the teacher if there are significant focus issues compared to the other kids. If the answer is "yes"...she probably has ADHD in my opinion. They probably won't come right out and tell you if they think she has ADHD or not. They will talk about "focus issues" and hope you figure it out.

Yes to what blackcat said. Also, it helps to do the observation in conjunction with a parallel observation of a non-identified (as ADHD or any other need) same-sex peer in the classroom, so that you can reduce teacher and task effects.

Freely downloadable checklists that most pediatricians recognize: (Vanderbilt)

http://www.uwmedicine.org/neighborhood-clinics/Documents/03VanAssesScaleParent%20Infor.pdf
http://www.nspeds.com/_files/Vanderbilt-Teacher-Initial.pdf

A nice practical book on ADHD interventions:

"How to Reach and Teach ADD/ADHD Children." Sandra Rief.

Books on executive functions:

"Smart but Scattered". Peg Dawson
"Late, Lost, and Unprepared." Joyce Cooper-Kahn.

I disagree. There is a HUGE overlap between SPD and "ADHD". We have just filled in the checklist forms for a 5th time, and yet again, the symptoms that are the same as SPD symptoms are in the red flag columns, nothing else is.

I also read a study about a year ago that proved that sensory integration strategies were just as effective for ADHD kids as for SPD kids. That made me wonder. Also, the less compatible the school environment is with her level of giftedness, the more "ADHD" she is going to *seem*.

From what you mention above it seems there are definitely sensory issues. Personally I would work on those before testing for ADHD as it may cause a false positive. JMO.

Spend 1 day with my DD and you will be convinced that ADHD is a real disorder and that there is no way sensory integration strategies would help in any significant way. Everyone can tell immediately if she is medicated or not. Her focus is 0-1 out of 10 unmedicated and 8-9 medicated. You can tell almost exactly when the medication kicks in and wears off. If sensory issues were causing all of her focus issues, that would not happen. A lot of people don't see SPD as a distinct disorder. The American Academy of Pediatrics recommends it not be diagnosed at all, unless it is in conjunction with certain disorders like autism, ADHD, developmental coordination disorder, etc.

Thanks for all the responses. She's a very young 1st grader (she was too young from her birthday but they made an exception for her). Her previous school definitely talked a lot about focus issue and like I said it was a Montessori school that made a point to work ahead with her on math (she was doing multiplication there, for instance). Her teacher remarked that even when she was doing subjects that she enjoyed (typically math/science) that she was easily distracted.

Her school does have a psychologist, so would that be the best route to go through for an evaluation? We were initially thinking of talking to her teacher directly after she was there for a few more weeks so she had known DD longer.

Honestly the line between SPD/ADD is confusing for me since there's a lot of overlap on the checklists and DD seems to hit most of them on both sides. Even as a young child we suspected she might have SPD but couldn't get it evaluated due to where we were living. It was only last semester after talking to her K teacher that we thought more in the ADD line.

I don't think many people doubt that ADHD is real. They just doubt that it is as prevalent as it has become. Also I think one of the diagnoses points is certain behavoirs persisting past the age of 7? As far as I know diagnosing a 5 year old with ADHD is a bit of a dubious practice.

Normally kids aren't medicated until around age 6, although I've heard of it happening earlier. The youngest age that a diagnosis is reliable--I don't know. I think it would be a good idea to keep your eye on it, collect information, and be prepared to evaluate when she is 6.

We're not hoping to medicate her. Rather, we'd like to seek out strategies to help her concentrate more and be less forgetful. It's quite often we'll ask her to do a very simple task (like grab a tissue) and the second she leaves to do it she forgets and gets distracted. She's also had issues with forgetting her homework at school too.

Arr. Lost a post. Shorter version: we have one much like this, who has since developed (with our help) effective cognitive and behavioral strategies, such that, while checklists still come out high, there is no disruption to major life functions, which is what distinguishes merely an interesting profile from pathology.

Meds are good for some kids, but not essential for all.

That's really what we're looking for. What did you guys do that worked?

newmom21C, I personally have the problem of leaving to go get a tissue and forgetting what it was I was doing by the time I get there. There was an article that got a lot of press a year or two ago for showing that walking through a door was a trigger for losing your train of thought. Since I read that article, if I leave to go do something in another room, I try to be consciously thinking of what I am going to do as I walk through the door. I have no idea if this is just a placebo effect, but it does seem like I forget less by using this strategy. You might want to share it with your DD, and show her the article if you can find it.

For me it's the stairs...our house has a LOT of stairs, and as soon as I am on a different floor - poof...
Then when I am back on the floor I started out from, I may remember...

We started from a philosophical point of view that is strength/asset-based. The ADHD-type traits of a child are only pathological (disordered) when they are not properly managed, or are in a poor fit with the environment. Our objective was not to eliminate or pathologize attributes of our child, or re-name them as character defects, but to restore autonomy, so that our child would be able to employ and appreciate those qualities as a choice, instead of being ruled by them.

Self-determination has been a major theme of ours, with all of our children, which includes self-management, responsibility, understanding and valuing oneself. Because this is a theme that is constant in our house, no one is singled out; each person (adults included) has a different set of challenges and resources. One person is impulsive and highly active: that individual is working on managing physical and verbal activity in such a way that one demonstrates respect for other persons’ physical and sound space, and their self-determination. Another is passionate and emotionally intense: this one is developing cognitive restraints for emotional lability, so as not to be incapacitated by emotional flooding, and also to avoid imposing overflow on unsuspecting bystanders.

Practically speaking, we started from heavily scaffolding behavioral and organizational expectations, designing for a high likelihood of success, and then faded supports gradually from one end or the other of the behavioral sequence as our child became more skilled. We treat every incident instructionally (unless there is clear evidence of a volitional element, in which case we try to separate the chosen from the unchosen behaviors and engage in a different kind of instruction—not always successfully, but at least we make it clear to the child that we are not trying to punish them for something that they didn’t do intentionally).

We use external supports to make internal executive functions visible. For example, using a timer to help define time-on-task/sustained attention. Discussing what it feels like when one is focused. Exploring the kind of internal and external cues that help one to remember tasks. Visual cues for transitions, task lists, and schedules. Constant, frequent, specific reinforcement and shaping of self-management behaviors. Leaving lots of time for multistep tasks and transitions (such as leaving the house for anything), so that we have the time to verbalize planning and organization strategies, and to allow supported attempts at implementing them. Collaboration with the child to problem-solve through difficult-to-change behaviors. Much repetition and patience!

I thought I was an exceptionally patient and gentle person before I had children; I learned that I still have a long way to go before I am the person I would like to be! (And I express this to my children, especially on the days when I am unable to live up to my own principles.) Be patient and gentle with yourself as well.

I guess this is more of a perspective or a guiding principle than a specific technique.

We are already seeing a difference doing edublox/audiblox.

http://www.edublox.com/

Thank you for taking the time to post this, I found it helpful!

Thanks for that! We were thinking about using a timer for some activities and it's good to hear that might help. I'll see if we can make some adjustments to our current routine. Right now homework has been a nightmare because even those she understands the materials it takes her forever to complete it because she's so easily distracted. She's also a serious perfectionist so that plays a lot into the time things take too.

JMO, but I think that I'd focus on "getting her evaluated" rather than "getting her evaluated for ADD". You've noticed that many of the things you've observed in her behaviors fit both ADD and SPD checklists, but you might not have noticed - they may very well fit into other lists.


This sounds like several of the children I've known you have ADHD. It also sounds *exactly* like my older dd at your dd's age… before we realized she some fairly severe vision challenges.

The thing that I think is key is to recognize that as a parent, you suspect something's up, but you're not going to get to the root of what's really going on just researching on your own. You need to have a professional observe your dd, interview you, go through her developmental history etc.


I'd ask her teacher about challenges she's having in the classroom, what the teacher is able to do (and what doesn't work) to redirect her etc. BUT - and this is important - remember that the teacher isn't a medical or psych professional. If the teacher tells you she thinks your dd has ADD, that's the teachers *opinion*. We've been in this situation with our 2e ds and a teacher (teacher was convinced he had ADHD), and also our dd who had the vision issue had a pediatrician who was convinced she had ADHD because she bounced off the walls every time she was in a dr's office. People who aren't trained to evaluate are only going to see what they have experienced seeing. Just as parents are only going to research the things they know about or read about. What you need is an unbiased global look at the whole child, developmental history etc. by a professional who is familiar with a wide range of possibilities.

polarbear

Round of applause for polar bear!

AEH thank you for what you shared. I was so muh better at parenting a full on child hen there was only one full on child :-)

I agree very strongly with polarbear... three different people at my son's school and a speech therapist who evaluated him all have different, confident opinions about what the problem is. The speech therapist commented that she was sure it was ADHD because that is what her own child has. We're working our way through more substantial evaluations as well, but I've become very frustrated with getting all of these opinions because I think everyone is focused on giving a label when I think the bigger problem is finding appropriate solutions (and those aren't always the same regardless of the label, but I think there is a tendency to choose a label and give standard recommendations rather than to really look at what is going on with a particular child, which may be complex and may include issues with different causes).