Gifted Issues Discussion homepage Forums Twice Exceptional ADHD, ODD and the Spectrum "Disorders"

Hi - I moved this thread from the Testing anxiety for the parent thread - becasue I wanted to share information I found this month in "Natural Awakenings" . Article by Dr. Mark S. Smith who works here in VA. He has 32 yrs practice in non-pharmacological treatment of both neurological and general health disorders and does free phone consultations. (I plan to call today). But this is the first thing I've come across since we got the ADHD diagnosis last week that mentions that all kind of coordination problems, including eye sight are linked to ADHD - so maybe Auditory is too - don't know.

My dad had almost complete deafness and acted very ADHD and also taught hismelf to read by 4 and ultimately speak 5 languages - so talk about 2E !!

DS6 has the "eye control" issues - with alignment. The article I mention is the first I've seen where someone says that ADHD and ODD fall into the Autistic Spectrum Group. So I'm slightly less skeptical of ADHD, knowing that they mointored the Alpha waves on an actual machine and didn't just "observe" DS6's behavior subjectively.

I've tried to read up on Aspergers and Autism the last few weeks too - and read a book about the left and right side of the brain by the scientist in Cambridge University who I think is the one that defined "Aspegers" as a very left sided condition/ male brain condition - so it was just interesting to see someone link everything in this way and take a non-pharmological approach.

To answer giftedcyper's earlier questions in the Testing Anxiety Thread.

Yes, DS6 was diagnoed ODD - oppositional defiant - and not OCD. However, not having experience of kids with OCD - hard for me as amateur to know what to look for I wouldn't have been entirely surprsied to get OCD too - just due to the "obession" level I see in regards to whatever inerestes DS6. He will literally build Lego right now - non stop for 8 hours + if you let him. Anyone else going through this with "regular" gifted kids? Or a 2E kid?

I read that ODD, ADHD, OCD and sensory integration nearly always present together if your kid has Asperger's - so I was leaning in that direction the past few weeks. DS6 is not exactly "in a world of his own" like Asperger's kids tend to be - but at the same time has done seemingly uncompassionate things or weird things - like stealing part of someone else's art work by ripping it right off which I hear Asperger's kids often do - becasue they want just one thing they are fascinated by.

So - DS6 is sort of in his own world in that even if he is sharing - it's all about him to the extent that he is almost not aware of anything else the other person may want to say, or do. At least at times. (It's not a consitent behavior).

The ODD sounds drastic and the behavior has definitely gotten worse in school and since Fall. However, there has always been behavior issue since early 4 - but not so much before. There was "constant movement/curosity/hyperness" if you want to call it Hyperness -but to me that was just an active very bright toddler.

Only after being exposed to older kids, and I think ED kids who yelled at Age 3 in Montessori did we see true behavior issues appear - in that DS6 would get more oppositional, yell, shout, have tantrums (but then, at 3- some tantrums still normal.) He complained of boredom and that he didn't like the teachers even back then.

Now - confined spaces on bus and "open spaces" like Hallways and Recreation area are still HUGE areas of contention where stuff went wrong more than in class - which got me thinking Asperger's /sensory overload- but apparently, right now anyway, doctor doesn't think Asperger's. It's really the level of language that DS6 uses that caused the suspensions - he has never been afraid of adults, won't automatically respect adults, and sadly following exposure to older troubled kids at Montessori learnt to say "I want to kill you, shoot you, blow up the school" etc. Coupled with TV - and you have recipe for disaster!

At Church school last year - we tried to explain why he coudln't say "kill people or blow up the school" ANYMORE by being honest about Columbine etc. despite his tender age. I figured maybe an honest approach of telling him the true story would help. He asked lots of quetsions about who did the killing and why for a several days. Unfortuantley - it did backfire - in that he now knows exactly what to say when ANGRY! And boy does he have a temper. Without that ability to use words - often out of context- and often without I think the full extent of their meaning in mind desipte his intelligence - I'm not sure the suspensions would have escalated - but all this leads to the ODD diagnosis.

Welcome feedback from anyone with similar issues or just an opinion and especially from anyone with experience using a non-drug appraoch to ADHD!!

Wow! That's a lot. How are you currently treating him? Have you checked out the resources at CHADD? Have you tried the basic magnesium/zinc/fish oil stuff? Jenny McCarthy (of all people) has a cool website at http://www.generationrescue.org/

Yeah sorry - can you tell I've been holding it "in" for about am onth due to my not having much time to "blog"!

As we only got the written diagnosis this week - not treating ihm with anything except diet and mountain dew (caffine) right now. However, he takes Omega 3 already and I really don't want to even start drugs. Way more to research on that before this stubborn mind changes on that one! But look at what could be at risk?!!

We are considering biofeedback - though with the attention span he has now at age 6 - not sure how successful thsi would be. However it seems like it might be more of a "cure" than "mask the sympotoms/dumb him down" type of deal.

Not to offend anyone using drugs - I have sevearl dear friends that do - I totally respect others for taking their decisions. I'm just not comfortable myself yet at all about the whole drug issue.

Does he show any empathy for things, people, pets, and animals? Does he get upset when others have bad things occur to them?

What does he do when he watches or reads "Old Yeller" or "Where the Red Fern Grows"?


OT: Its interesting that you mention Columbine as Klebold was GT and that is why he was attending Columbine.

It depends. He watched "The Snowman" British animation that was a book and DVD - 25th anniverary this year. when the Snowman melts at the end - he said it didn't bother him . My brother and I used to HOWL over that !! (Well almost). It just depends.

He's loving and instantly sweet one moment - angry the next. He "flew a baby tortoise" around the room 2 summer agos and even though it literally "screamed/sqeaked" in fright - he acted like it was of no concern.

He has bitten coats, pulled on sweaters, pushed kids out of the way - because they don't do what he wants or needs as fast as when he wants or needs it.

He will yell when he does not get his own way and slam doors. He has told the Principal "I'm sorry, but will act the same way in class tomorrow". He has demanded "Now send me home".

He once stabbed at someone's hand in Montessori with a "pin puncher" - little pin they were using to punch out the continents - becasue that person interupted his work.

The doctor had the behavior journal - minus the earlier incidents .....but was trying to show me that my kid doesn't have Aspergers' because he didnt' have every single item on the "list" in his "little red book of diagnosis" - which he litearlly pulled out - it really is a little red book!!

I remain somewhat skeptical.

At other times - we all get hugs, loves, kisses, sympathy - but its a very egocentric world at times for DS6.

I don't really have an opinion, just a little thinking-out-loud on these issues (uh oh). I have read that people with ADHD tend to be (though not always) right-brained, visual-spatial learners. (mostly in Silverman's book; see also http://www.visualspatial.org/Articles/george.pdf ) And I do feel like I keep seeing other issues - sensory and motor in particular (though ocular motor is really a subset of sensory processing disorder) - in right-brained, VS learners like two of my kids. I think it may merely be that the sensory/motor stuff represents different sorts of left-brain weaknesses. As for the ocular motor, somewhere in the course of vision therapy I think I read about cases that were misdiagnosed as ADHD - but misdiagnosis is a very different issue from the issue of whether adhd and ocular motor issues are linked.

I wish I had input on OCD tendencies - my dd tends to have both a defiant and obsessive need to speak a certain way to me (essentially backtalk that I "cannot allow"; what does that even mean). It was part of the reason we did OT for SPD. Thankfully it's improving with age, though when she's tired, etc. it rears it's ugly head. But it never rose to the level of ODD with other adults, so I don't know anything about that - it's been too long since I read about the topic.

I am not familiar with ADHD as being a "spectrum" disorder and frankly without more I think that carries the spectrum (as vague as it is) much too far. AHDH has its own specified DSM criteria to begin with, and I thought the "spectrum" was PDD-NOS, as in "not otherwise specified", such that by definition it could not include ADHD. Meanwhile, I don't necessarily see any link between autism proper and ADHD except that again they may both tend to be right-brained thinkers.

I thought ADHD isn't usually diagnosed until around 7 y.o.?

I guess my bottom line opinion is that plenty of these issues (sensory, motor, adhd, odd) exist on their own, and the fact that some people tend to have a group of them does not mean they are necessarily linked. My guess is just that the issues are different kinds of left-brain weaknesses in right-brained thinkers. I think the spectrum stuff is a separate animal as well, since plenty of people have sensory issues, for example, without being on the spectrum. I hate that there even is a spectrum because I think it is so ill-defined, which ultimately leads to more difficulty in communicating about a particular child's situation rather than less difficulty (too many different pre-conceived notions of what it means). With that kind of vagueness almost any issue could be called a spectrum disorder, even though it may have no relation to actual autism whatsoever. At least with autism the DSM criteria are more specific, involving severe lack of empathy.

It was probably a bad idea to think out loud on this board on not enough sleep. But that's my two cents - I can't comment on the ODD, but as far as the ADHD goes I'd need to have someone spell out for me why they think it should be considered a spectrum disorder because it doesn't make sense to me. It sounds like the guy who wrote the article thinks that all such people, who are right-brained thinkers with any left-brain weaknesses (ok, that probably would include me LOL), are on the spectrum, and that pathologizes far too much of what I believe are normal ways of thinking.

ok I better stop now before I say something even more dumb...

I guess I should have added some advice for your situation! My only advice would have to do with the sensory/motor stuff, but re-reading your post I think it's the behavior you're most concerned about and whether the diagnoses are correct? If you are doubting that he doesn't have Aspergers, you could always take him for a second opinion. What do you think, personally, about whether he meets the criteria? I think that thought may guide you. I think there are actual DSM criteria separate for Aspergers, right?

Also, there's a book I love that discusses many of these issues, "The Mislabeled Child" by Brock and Fernette Eide. I think they also have a website. The book discusses the similarities, differences and overlapping symptoms among many of these types of issues.

I agree with snowgirl's reflections on putting AD/HD on the Autism spectrum. I don't think it serves either population to do that because they require such different treatment.

Anyway, I don't think Asperger's is situational. I think it's a round the clock sort of thing. I also think that telling the principal that he'll act the same way the next day is an attempt to manipulate emotions. It certainly isn't nice, but it does reflect a certain amount of awareness of other's feelings. What would you do with an Asperger's diagnosis anyway? How would that help him? I can think of a lot of ways it could hurt him but right now, it sounds to me that you've got a lot to work with with the two existing diagnoses.

Has he seen a psychologist? Your doctor could help you find a psychologist that specializes in AD/HD and ODD. That would be my first move. I don't think AD/HD is the primary problem. I think you have to address the ODD. In other words, find out if he has an anger issue to address and if not, start a hard-core discipline program at home combined with a behavior mod program in the office. There's a book called 123 Magic that pertains to raising a kid who's been diagnosed with ODD.

Also, I should have mentioned that I'm sorry you're going through this. Have you thought about taking him out of school for a while? Is that a possible option?

Thanks for the responses. Yes. I'm really curious to hear how this doctor plans to explain lumping all the different conditions he mentions onto the "Spectrum". I wasn't trying to suggest that Asperger's is situational etiher - so if I gave that impression that wasn't my intent. I'll let you know what I find out.

Thanks for the book suggestion. I am very interested to read the Mislabled Child - problem is fitting "all the books" in.

I am not planning to remove him from school rightn ow as on the whole its been going much better, and at least now they know there is a diagnosis and really high test scores. Up until this point I've suspected that they've all been thinking my kids need to be on drugs - but they've also been acting somewhat slow and skeptical about the fact that he is pretty smart - espeically as ADHD, ODD and giftedness have such simliar "symptoms". Hard to tell where one thing ends and the next begins sometimes.

Have you read much on Gifted Aspergers? Please take this in to consideration when considering aspergers. Much of the information out there is not geared toward gifted aspergers. It will make a difference. If you haven't already please read Giftedness and Asperger's Syndrome: A New Agenda for Education by Shelagh and James Gallagher. You can google the title. Pay particular attention to the tables listing differences between them. It also includes the Diagnosis Criteria for Asperger's Disorder. Your child would manifest two of the six in A, and at least one of six in B, you then need to be able to answer no to C,D,and E. Your child does not need "all" of them by a long shot.

From there you need to determine if you really need a diagnoses or just go with what treatment might be warranted for the existing symptoms. My oldest DD9 has gifted aspergers and the accompaning or coexisting ADD, mild to moderate ODD based on ACTers testing, and SID. We have used meds at the beginning and gave up, they helped in her opinion but not enough to warrant dealing with the side effects over time and we couldn't find the right dose to eliminate the side effects. I'm not ruling them out as a possibility in the future but not for now. We are using behavioral modification and working with the speech therapist on social skills and pragmatics, in particular with a new book out that is really good. It's a pictoral representation of appropriate social skills, many people have asked the name and I need to find out this week when I see her.

One of my DD6's is also "on the spectrum". We tried drugs with her and took her off as well. It can make for an interesting day at times, and we plan to test her in the next year to see where we are there. The school had made a big push to put her on meds. We are using Brain Ware Safari right now and seeing some progress with her attention and impulse control. You can find information on it on their website if you click on professionals and then on the left hand side click on behavioral impact. We purchased it through the homeschool buyers cooop for very little compared to their regualr prices.


Just so I understand completely, is the current diagnosis ADHD and OD?

Yes, this was ADHD and ODD. I still think he may have Asperger's - but its hard to tell. His "spark" and the peaceful happy look in his eye returns the minute he his home learning for a day or two with his dad. I work with him in the evenings. School seems to leave him totally depleted, not as happy, just hard to put in to words, but he is just different and at Christmas he was a totally different child after 10 days at home. The hyper comes and goes, and coffee definitely seems to affect it - calms him down. If other parnest havent' used just plain caffeine - whether from Mountain Dew (diet) or Dr. Pepper I hear now has the most (again diet - or you get a sugar spike) they may want to try it. Though I was also told that Aspartane affects *some* people's brain chemistry - so they you are stuck with Splenda Diet coke as an option I think!

I'm totally anti-drugs still and looking for alternatives. All the "side effects" under eye blinking thread alone have merely turned me off more!!

Thanks SO much for mentioning the book and summarising those tables. That may well help if he does need extra help, to stay in school or to return to school if we decide to home school for now. Plus, I just want to fully understand him of course. I also have many friends with Aspergers kids - who are very intelligent or have great gifts in art or something else - and often the parents are so concerned with just dealing with school and Aspergers and keeping the child in the special ed program - they don't even recognize, realise or care to deal with the giftedness aspect. It's of great concern to me and should be to us as a Nation / Globe I feel - that the US system anyway is separating out the 504 programs and Special Ed programs - with no accommodation for 2E. It ends up becoming in the parents' interest to go with Special Ed - and not even explore giftedness for fear of losing Special Ed. services or not gaining them to begin with. Imagine how much is being lost in potential. That's just plain wrong! So I will deifnitely share your resources with others I know. Thank you, thank you, thank you!

I don't think you can ignore the gifted aspect and do justice to the child. My daughter does so much better when she is challenged academically than left to mumble along. We are continually evaluating to see when/if it would be in her best interest to pull her back out completely or move her further ahead in ELA. For now her partial enrollment with services is working. I think a big part of why it's working is because she is able to move ahead at her pace with her other subjects.

I love the book Genius Denied. I completely agree with the loss of potential that we are putting on some of our brightest kids. It's very sad.

My son (dx'd with nvld and Aspergers) must have special ed services because I have no choice. He is barely willing to access his education because he is so fixed on what he wants to do/his interests It is much more complicated with an aspie profile becuase the social impairment is an impediment along with the self-directed interests that preoccupy a child on the spectrum. It does not wax and wane. It is ingrained in them and is constant.

As far as I know, ADHD and ODD (the ODD I would refute as a diagnostic category) are not on the spectrum or considered to be by autism specialists in the field. ONe considered change is adding NVLD to the DSM and Aspergers as a social disorder seperate from the autism category.

btw: Professionals like to overuse the ODD because it is easier to understand and requires less of them. No gifted child should carry a diagnosis of ODD which is loaded with negative connotations!

Well, I agree on the ODD thing. I was horrified that they assigned to DS6 - but then - there's no denying he's obstinate, willful, unafriad if adults and defiant - and been that way for more than 6 months - which is their criteria. However, it does have very negative connotations compared to a gifted child acting out or not being afraid of adults.

I spoke to the Board Certified Chiropractic Neurologist yesterday - and challenged him on the whole "why did you say in your aritcle that ADHD falls on the same spectrum as Austism and Asperger's a lot of parents don't find that helpful". But apparently - that's the way its viewed officially by the neurologists he has trained with. It's not that they are saying they are the same condition though.

Of course - some people hate Chiropractors - so that's a different argument/discussion.

I'm curious to see how he treats DS6 and if the exercises they give him help strengthen the weaker areas of his brain causing the eye problems and possibly the ADHD. In the meantime, we'll see whether home school and challenge and maturity improve things too.