Gifted Issues Discussion homepage Forums Twice Exceptional It's official!

We went to the developmental pediatrician on Tuesday, and while we will have our official follow-up next week, the doctor said ds is the classic gifted/ADHD combination. She pointed out the slower processing speed and working memory and explained how that affects his writing in particular. We are going to try medication combined with some classroom and home interventions. I'm praying this works for ds because he is so frustrated with his difficulty focusing.

I'm still trying to make some decisions about schools for next year. Is there anything in particular that I should look for in a school now that I know for sure my son has ADHD? I know there are certain aspects of a classroom educational approach that work best for gifted students, but what about ADHD? Is Montessori good for kids with attention problems? With successful medication intervention, do these things become less relevant/necessary? I understand kids who have ADHD need order and routine, but my ds (I assume b/c of the giftedness) gets really bored with routine. I do too, so I can relate. How do you balance a child's conflicting needs with this 2e diagnosis?

Thanks for any advice you can provide!

I'll be curious about your experiences as well. We had a consult at the Gifted Development Center where they told us that dd#2 "definitely" had ADHD inattentive type due to her erratic achievement and ability scores but the woman with whom we met was also fairly rude and had never met dd so we weren't sure.

When we had her retested on IQ and achievement by a psych she told us that dd definitely did not have ADD/ADHD. Her WM and PS were also low or avg with the other two subtests gifted.

We've suspected ADHD for a while, however, we wanted to be VERY sure before seeking an official evaluation or diagnosis. I wanted to make sure it's not just related to giftedness and being underchallenged or something else entirely. The developmental behavioral pediatrician looks at the whole child and performs very thorough physical, behavioral, developmental, and neurological assessments. Ds had to do some writing and visual processing tests, reading tests, reading and following directions of increasing complexity, coordination tests, etc. Of course, throughout this process they were observing his attention and focus and ability to initate and follow through on tasks.

In addition to the eval, the parents and teacher(s) complete an extremely lengthy and thorough questionairre about developmental history and behaviors observed at home and at school. The doctor then asked a lot of questions about ds's development from birth to present. She didn't leave any stone unturned. She even asked me about every child care situation he's ever had, birth, infancy, preschool, etc. Here's a brief explanation provided on this particular doctor's website for what to tell your child when he/she is going in for an appt:

"The nurse will check height, weight, vision and hearing and will also give vocabulary and fine motor skills tests. The doctor will do a physical and neurological examination, and will assess language and motor functions. There is no pass or fail in any of these tests. What we are trying to do is determine the child�s learning and behavioral style to find ways to help with schoolwork, behavior and getting along with friends."

It was expensive, but a lot of it will be covered by insurance. We just have to submit our claim ourselves, as the doctor doesn't file insurance. I knew I'd question the diagnosis if we didn't do something comprehensive like this. There are psychologists and psychiatrists who also diagnose ADHD. I, personally, felt better with this doctor than going that route, but a lot of people are very confident in their psychologists and/or psychiatrists.

Our doctor has seen it all, and doesn't just go in to confirm or discount a particular diagnosis. She looks for anything and everything. I trust that the diagnosis is accurate. She was so knowledgeable, and everything she said just made sense. She spent a few hours with ds, and she could describe him to me like she's lived with him her whole life.

My best friend used this same doctor for her son, and she was equally impressed. She agreed that she needed some kind of assessment like this to trust the diagnosis.

Oh, and another thing I like about her is she's not quick to just prescribe medication. She really looks at the individual situation and respects a family's feelings on that subject.

We were certainly not shocked about our son's diagnosis either! My friend told me that I needed to be ready to hear it before I took him because if I wasn't ready it wouldn't matter what a doctor told me. She was right. I knew it was time, and that made accepting the diagnosis much easier. It's actually a relief now just to have a plan.

Jen,
The one thing I found really helped my younger son was getting put in the classroom of a teacher with a very even keel. He has been in classes with nice teachers before, but when he would act up, or start working himself up, the teacher would get stressed or upset and DS7 would find himself being unable to calm down. The emotional levels would just keep climbing.

This year, he has a teacher who admonishes him when he's bad, praises him when he's good, but does not take his behavior personally. He is thriving. Because she does not react to his behavior with any strong emotions and she helps him think about his action, he has been calming himself down quickly and had very few issues.

I don't know how well this will work with other children, but that is the only experience that I can point to that has helped a lot.

Thanks for the update JenSMP. I will be watching your posts for sure. Please keep us all in the loop on your DS and meds.

Some school districts complete conners scales, or abridged versions of the scales, or if their could be other behaviors or questions they may complete the BASC or CBCL and will forward copies of their report to pediatrician or doctor...they don't actually do the testing or diagnosis themselves. Just share their report or evidence and the doctor then meets with the child to see what they are seeing.

Lauren,
The developmental behavioral pediatrician did base the diagnosis largely on parent and teacher questionnaires. They were very extensive questionnaires, and you do rate many behaviors on a severity scale. Once we begin medication, we continue to do the questionnaires on a regular basis to measure changes in behavior.

There are criteria that must be met to make a diagnosis. For example, the symptoms have to exist in multiple settings, must be present for an extended period and present before a certain age, and the behaviors/inattention must affect the child in some functional and/or educational way. In addition, they do tests to rule out other possible causes, like oppositional defiance, anxiety, schizophrenia, and other psychological and/or physical conditions. I like the idea of seeing the developmental ped b/c she checks for developmental, neurological, and learning disabilities as well. In fact, there's one thing she tested for, can't remember what it's called, where she asked ds to perform some tasks that required him to move one side of his body. She looked to see if he moved other parts of his body as well. She found with my ds that when asked to touch his left shoulder with his right hand, for example, he also moved his left hand and his tongue. He's notorious for moving his tongue when performing other physical tasks like playing basketball or writing. She said this is very typical with children with ADHD, so it just provided more corroborating evidence for the diagnosis. I feel much better going this route. I don't think I would have trusted any school to diagnose ADHD. How old is your son?

We went through all of those same possibilities and eventually determined that yes, ds does have sensory integration issues and some anxiety, however we feel that these are a result of the ADHD/Gifted combo, not the causes of the ADHD-type behaviors. Does that make sense? It took us a while to get to this point. We questioned for a long time if the problem was just that ds wasn't challenged in school. We now feel sure that he is being sufficiently challenged, and his inattention is worsening rather than improving. It's even getting worse at home. So, I understand completely why you're not convinced. It's so confusing, and all of these things tie in to each other so closely. We just got to the point that no matter what you call it, it had to be addressed. I'm scared to death to give him medication, but it's gotten severe enough that I know organizational strategies and classroom interventions alone are not going to be enough. Interestingly, ds also seems to have allergies. At this time, we give him Nasonex daily (which helps slightly), but we don't know what he's allergic to. I guess that will be the next thing we explore. When does this parenting thing get easy?

I think that this is the biggest pain of having 2E issues. You look at everything and see the gray area of the kids behavior compared to the diagnostic extreme, and you have to work so hard to tease it out. Good luck Jen, and let us know how it goes...I might eventually be faced with this decision, and I am terrified of it.

Artena,
Thanks for the support. I'm praying this weekend is a success.

Lauren,
We have not had the skin tests done. With ds's hypersensitivities and over reactions, I think it would be a nightmare. We had to have blood drawn once, and it was insane. The thought of going through any sticks just might send all of us over the edge. I guess ds needs to get used to this kind of thing sometime, but he's petrified of shots or anything to do with needles. I'd hate to go through the testing and not have any answers.

When he was younger, ds had eczema. It's better now, but he still has very sensitive skin. It will flare if we use anything other than the dye- and perfume-free detergents. Perfumed lotions make him itch like crazy, and we have to use Dove or Ivory soap. He also has a runny nose almost all of the time, and when he's introduced to a new environment (like a new classroom), his runny nose becomes almost distracting. The teachers always think he has a perpetual cold. Like I said, the Nasonex helps a little, but I do often wonder if there is some other kind of trigger other than environmental. He had allergy testing done at age 2, and they said he had no allergies. I've heard, though, that testing done that early is often not reliable.

My good friend was over today in tears over one of her three children. It seems that we all have some sort of issue with our children. I have very few friends who don't have significant concerns about their kids. What is going on? Are we exposed to more pollutants or hormones in our foods? Have we just become helicopter parents worrying about every little thing? Do the kids not get as much exercise as we did? Too much TV? I guess there are no really good answers, but it's certainly strange that the prevalence of disorders such as ADHD are on the rise. I used to think people just jumped to that conclusion b/c it was convenient. Now I know that it is very real and just how debilitating it can be.

Lauren,
If we are all crazy, should you be asking us? LOL

I'm sure you're right that a big reason we see more cases of ADHD is just better identification and understanding of the disorder. We're lucky that it is treatable considering when we were kids we had to just figure it out on our own. Not that my life was really bad, but I think a lot of things could have been different if I'd been diagnosed. I feel sure that I have ADHD. I cope well, but life can be frustrating at times. It's always been that way. I always made straight A' in school and tested in the top 2% of the nation on standardized tests but I never attended any gifted or advanced placement classes. My strengths were never realized or identified, probably because I was always in trouble for talking, impulsivity, and as a teenager, for being rebellious. I still remember not being able to go on the 7th grade trip to Washington D.C. even though I made straight A's the whole school year because I had poor conduct grades for talking too much in class. I'm not bitter or anything though. ; ) LOL I was so devastated and remember being completely shocked. I was unaware of how severe or disruptive my compulsive talking was. I do remember being told to be quiet (again) and thinking, "I can't believe I was talking AGAIN!" I would get really frustrated with my lack of self control.

Anyway, I hope it's true that we're not seeing an increase in the incidence of ADHD and just an increase in proper identification. I keep wondering what I've done wrong or if I've contributed in some way (other than unfortunate genetics). Tonight was a rough night at basketball. DS was completely unfocused to the point that I noticed other parents shaking their heads at him. The coach was very patient, but he must have said my son's name 400 times during the 1 hour practice trying to redirect him. It was all I could do not to cry in the middle of the gym. Hopefully things will look up when we start the medication on Saturday. I feel so bad for my son. He's really struggling. I know it could be so much worse, and I really need to count my blessings. Sorry for the pity party!

I have found writing here helps vent some of the stress. Writing also helps to think thru your situation. Kids in general are a lot of work. Then put being gifted and ADHA on top of it and WOW. Post what ever you want because that why this is here.

Hugs to you.

Thank you!

I am so frustrated right now. We were all set to start the medication tomorrow, and the prescription didn't come in the mail today! I'm so bummed. It's like I've been keyed up over it all week, and now that we're finally setting a plan into motion, it gets delayed! I know it'll probably be here tomorrow, so we can probably start the medication on Sunday, but I was really glad we were going to have a 3 day weekend to observe ds on the meds. Now we'll only have 2 days, and if it doesn't get here tomorrow, we'll have to wait another week. Ahhh! Just venting as usual!

It will be alright! If you call the doctor's office and offer to come pick up the Rx, a) will they do that, and b) can you get it picked up?

Best Wishes,
Grinity

The doctor is about 2 hours away, and they are already closed for the weekend. I left a message asking if they could just call it in and maybe the pharmacy could fill just one or two pills to cover the next day or two. But, the office closed at noon, so I probably won't hear back from them. Because it's considered a controlled substance, I guess they usually don't allow it to be called in. The pharmacy requires a written prescription.

I called the post office, and they said it should be here tomorrow. They were surprised it didn't make it today, but said something about having bad weather. We've had lots of rain, but should that slow down the mail from a city 2 hours away? I guess we'll just have to wait a day unfortunately.

Lauren,
DS's school is actually really great about keeping in contact and observing his behavior. She gives me a detailed report at least every few days but never dwells on the negative. She's very objective, and we are pretty sure we're going to keep ds at the school next year. We've been wavering on that, but considering how supportive and loving they've been to him through this transition and diagnosis of ADHD, I can't imagine finding anything better. At least for now, it's working, and ds is even starting to like school more. Finally, when I pick him up he says his day was "great." Plus, I think the consistency will do him some good. He's had so many changes already.

The prescription just got here a few minutes ago, so I'm going to go fill it now. The doctor told me she would mail the prescription separate from the report so it would get here quicker. Whoever mailed it put the Rx in with the big package containing the report, so I guess that's why it took an extra day to get here. Oh well. We have it now, and luckily it's a long weekend. We will have 2 days to observe before sending him off to school Tuesday.

Thanks for all the support. I've really needed it this week. Have a great weekend, and I'll post an update in the next couple of days.