Gifted Issues Discussion homepage Forums Twice Exceptional ADHD & Developmental/Behavioral Pediatrician?

We are planning to schedule testing with a Developmental & Behavioral Pediatrician to asess for possible ADHD and writing difficulties. We really do not have any other concerns beyond those. For those of you who have had your children tested for ADHD, did you use a Developmental Behavioral Pediatrician or a different practitioner?

Interesting question. We have an apt tomorrow with his ped to figure out what we should do. I'm not going to be comfortable with her diagnosing him with ADHD herself (though we love her and think she's a great dr) but will want a referral to see a dev ped or someone else.

With my DS there are also some possible concerns about something else so I am going to push to have a full eval done if possible to rule out anything on the autism spectrum (though I think most of it may be gifted related so if we can't get an eval done we'll pay for testing ourselves to figure out where we're at)

My son was diagnosed with suspected ADD-Innattentive type by a psychologist after a full work-up, but since he is not an MD with prescribing priveledges we then had to see our pediatrician. I know many people just go to see a pediatrician, but I think I personally would feel much more secure in a diagnosis -- or a lack thereof -- if my child saw a developmental pediatrician or a pediatric neuropsychologist or some other more specialized MD. Of course, your mileage with a pediatrician would vary based on his or her level of experience.

That's what I'm thinking. I'd rather ds see someone who specializes in this kind of thing. Otherwise, I'm just going to question the diagnosis if ADHD is confirmed.

My general feeling on this is that going to a pediatrician for medicine first would be like going to a psychiatrist to set a broken bone.:) The pediatrician does not have extensive knowledge of how to diagnose the disorder, so they could diagnose and prescribe incorrectly. It's better to go to the psychiatrist first, and do a full evaluation.

I would definitely agree with going to an expert in this arena. Maybe even a couple. I have a nephew that was on meds for ADHD for years that were prescribed by a regular ped. I think he started them at age 5 or 6. At some point his mom did some research and had him reassessed. Needless to say, he has been off meds for a while and is doing great. He's an 8th grader now. She has made a few dietary changes for him, but it's highly unlikely that he was ever actually ADHD.

We will not be seeing our pediatrician for this. She is a wonderful doctor but does not specialize in ADHD. We are planning to see a Developmental & Behavioral Pediatrician who does a comprehensive developmental assessment. They will look at motor development, learning and behavior styles, handwriting, physical development, neurological development, and language development. The idea is to assess the whole child and not look for one diagnosis. They attempt to rule out other possible causes of the ADHD symptoms, but at the same time diagnose ADHD (or other learning or developmental difficulties) if warranted.

I was just curious if anyone else used a different practioner than this for an assessment. Artana recommends a psychiatrist. I'm just not sure which one makes more sense. I feel certain we are dealing with ADHD. I'm quite familiar with it, and DS fits the bill. The thing that's really been throwing us off is that we didn't want to confuse typical gifted behavior with ADHD since ds has not been in a challenging enough educational environment...until now-and we're still seeing the same behaviors. Now that it's affecting his ability to complete assignments and progress at school, we have to do something.

Both my kids were referred to a developmental pediatrician by their regular pediatrician when my son�s teacher and principle suggested that he may have ADHD (the principle and THIS teacher also recognized that he was intellectually advanced). My daughter was referred to the specialist at the same time due to my assertion that she seemed to present as having CAPD (one psychologists thought she had ADD, two others thought she had ADD and/or auditory processing difficulties (public school psych stated that she was quite average with pushy parents).

The developmental pediatrician determined that ds was very gifted and under- challenged (with borderline auditory attention issues) and that dd was gifted and needed further specialist evaluations for probable auditory discrimination and processing difficulties.
The developmental pediatrician also conducted extremely thorough physicals on each kid. While doing so, she detected an irregular heartbeat from ds which led to an additional referral to a pediatric cardiologist. (The conclusion was that he has athletic heart arrhythmia.)

I would definitely recommend anyone see a developmental ped for a diagnosis for ADHD. One caveat is that she did tell me that she hardly ever sees kids that are well adjusted, intellectually advanced and social with adults so she enjoyed interacting with them. Point being that, every developmental ped may not be experienced or aware of how a gifted children present with and without ADHD (similar to the issue of psychologists for IQ testing).

I think what delbows said is the crux of everything. If a psychiatrist/dev. ped. is really aware of giftedness and what it entails, you will get a different view from someone who is not used to dealing with gifted children. I have had this experience and I think others on the board have also. That said, I have not been to a dev. ped., so I apologize for my general comments about a ped, since it sounds like this specialization is different. I have been to psychologist, psychiatrists, and neurologist to speak about my children, but this is a new specialty for me.:)

cricket3, I understand what you are saying...I'm not sure I agree in the sense of possible DSM issues, but I agree in every other aspect. I do think of pediatricians as generalists, and I would go to them rather than a specialist right away for any physical ailment my sons have.

JenSMP - if you are looking to do behavioral techniques with your DS first, then my recommendation is not a psychiatrist. I would say go to someone who does not have the ability to prescribe meds and is more likely to do Cognitive Behavioral Therapy. On the other hand, if you do feel that it is severe enough to need medical intervention, then...like I said in my first paragraph...I have never seen a dev. ped or heard of one until now, so I can't recommend against it.

That's exactly what I want for my DS and will be requesting a referral to one today at his apt. I don't want a simple yes it's adhd diagnosis I want to rule out other things that could be mistaken as adhd (like being underchallenged, etc). We've noted that school days are when he is worse at home so I really think being underchallenged at school may play a big part in this behavior as well.

Our ped is great but I want an overall that I know isn't something they do in the ped office.

We've tried every possible ADHD strategy and behavior mod intervention. They are certainly helpful, but not enough to prevent significant difficulties at schools. I personally do not think they use of ADHD interventions/strategies alone are very realistic except with mild ADHD. I think in my son's case, the probable ADHD is not severe, but it's certainly more than a mild case. My son does not have severe hyperactivity, but he is in constant motion, and most of all, he does have pretty severe inattention/lack of focus. It seems to be getting worse, in fact, as the demands of school increase. I think we are probably at the point of trying medication, so we will be asking about that. I don't want to jump into that if there could be something else going on, however I no longer believe it's just a matter of being underchallenged. DS is affected in most aspects of life to some degree, but it seems that school work is affected even more significantly now. We went ahead and made the appt with the developmental/behavioral pediatrician for next week.