Gifted Issues Discussion homepage Forums Twice Exceptional ADD assessment

We are pursuing having dd10 assessed for ADD (not the hyperactive physical type). Dh is likely someone with ADD who was not dx as a child. He said that sudafed has always helped him focus and just has a lot of the symptoms.

Dd has been IQ tested twice -- once with a GAI in the upper 140s, once in the upper 120s. Either way, she is likely gifted to some degree. The second psych who tested her assured us that she did not have a LD or ADD based upon her WIAT (achievement) scores all being higher than expected given the second set of IQ scores and based upon behavioral forms filled out by me, dh, and her teacher at the time.

My behavioral forms did indicate a concern for ADD, dh's indicated that she had everything from schizophrenia to bi-polar, and the teacher's indicated nothing. Dh's assessments are basically useless b/c he is a hypochodriac and really negative. I recall one of the questions asking about her pulling out eyelashes and eyebrows to which he responded "frequently." When I asked him about it (she never pulls hairs out), he said that "she could." I told him that they were looking for what she does, not what she could do.

The teacher's form put everything in the typical range but she really didn't get dd. She was the one who told us that the IQ scores were due to "good guessing" and she wrote that dd was "nothing special" on her forms for the psych.

In any case, due to seriously erratic school performance, difficulty focusing, constantly getting distracted while reading (it takes her a good 9 months to finish a book), careless errors (including missing entire pages on tests -- i.e. completely turning past one page and not answering any of the questions on it b/c she didn't notice the page was there), and some other issues, I am really at the point where I feel like ADD is a real possibility. I am also feeling like it is significantly impacting her school experience.

I contacted our insurance co to see if we could get them to pay to have her assessed. They were rather shocked that a parent would be self-referring and wanted to know why her school and/or ped wasn't making the referral, but they do seem willing to pay.

The thing is that her teachers are unlikely to see a problem b/c, even at her worst, she is an average student and doesn't perform below "proficient" or the 50th percentile for grade. If we go the route of behavioral scales again, I don't think that we are going to get an accurate picture of what is going on.

Is there any other way to dx ADD other than subjective opinions of parents and teachers? The psych at our ped's office seemed to feel so, but he is out of network and it would cost us $800 for him to assess her. We paid over $1000 a bit over a year ago for the last IQ and achievement test piece and it just isn't in the budget for us to spend that much again when we can have it done virtually free through insurance.

Thoughts or advice?

I wish I could help, but I wanted to let you know that you're not alone. DS12 was always at or above standards in school and was not a behavior problem at all, so his lack of paying attention in school was rarely noticed, and when it was, it seems like it was just attributed to a personality flaw of some type. We suspected something was not quite right for a long time, since his school performance was so different than what we had seen from him before starting school and really struggling (despite always performing fairly well, if inconsistently). When he switched schools last year, the teacher noticed that he seemed to take a long time on tests and homework and suggested he might have trouble paying attention and suggested we might want to look into it. The school did not, however, make a referal, so we had to call our insurance provider and ask which psychologist would be approved to evaluate him. I actually didn't end up liking our psychologist much, even though he was educated in gifted children. The assessments we filled out (us, his new MS teachers who barely knew him, and his previous teacher who really didn't get him), came back all over the place, but suggested their might be a mild attention issue. In conjunction with an IQ test that had dropped 20 points from one he had taken years before, we decided that attention issues might be at play and the psychologist suggested a trial of Adderall. We then, of course, had to go to his pediatrician to actually get the prescription filled and had to head off the complete reevaluation she wanted to do on her own (we felt no need since we'd just done it!). In the end she agreed to write the prescription.

The results for my DS were not dramatic, as we were told was likely since he was being treated for inattentive ADHD not hyperactivity, where the results are usually dramatic. But, we did see him not losing his train of though when he was speaking, he no longer forgot something in his locker almost every day when we picked him up from school (this rarely happens now), and we did see his grades go up. He still has to work really hard at school, but he does seem a bit more together in general now. It hasn't been a magic bullet for us, but it's helped a bit, and the success of the meds, mild though it is, does seem to confirm that the diagnosis was correct.

I should also note that, since we had a private evaluation, we had the option to not inform the school of the results. We liked this. Eventually (after 5 months on the Adderall) we told his teacher that he was taking meds, but we have not told his current school because his behavior is not an issue and he now seems like any other kid in his class. We just worry, rightly or wrongly, about them looking for problems and don't want him pigeonholed or their opinions of him affected by anything other than what they see.

HTH!

This is an interesting comment. Where did you hear that the results of meds are lesser with inattentive type ADHD? Inattentive type is what we suspect.

I, honestly, haven't been gung-ho to medicate dd b/c she is very small and I don't want to stunt her growth. She's newly 10 and weighs 55 lbs. She's also short, so it's not like she's emaciated. Dh is just 5'6", so the genetics for big size aren't there.

I am willing to consider medication, though, at this point. However, if it isn't likely to net a significant benefit, I would be less eager.

I have a child that has ADHD-inattentive type. After 2 years of denial and trying to rule out other issues, we finally decided to try stimulant medication. DS showed remarkable improvement immediately. We chose not to inform the school, but the very first week we got a call from both his teachers telling us how great he was doing.

It has been 5 years and we have increased his dosage twice and are on the verge of increasing again as he has hit puberty and it seems to be metabolizing too fast.

It was very uncomfortable for me to agree to medication and even consider the possibility of ADHD for my very calm and well behaved child. More uncomfortable since it is a clinical diagnosis with so much gray area. That said, there were significant indicators that we finally captured on the ADHD rating scales once I was willing to be honest and within his psycho-educational testing. (For him, very low processing speed relative to other index scores).

Medication does not change him, yet he tells us he is better able to cope and follow what is going on. I notice that he stays more on topic during conversations, gets his homework done more efficiently and is able to complete tasks and remember what he is doing. He still has reading disabilities and difficulty planning his approach to new tasks. But, medication allows him to attend better and to remember the strategies he has been taught.

Finding the right the medication and dosage is a trial and error thing. Sometimes it is hard to know if you have the right dose or if a bit more would be better. Sometimes different brands within the same class work differently from child to child. For these reasons, it is important to consult with a physician that is an expert in ADHD: a psychiatrist, neurologist, developmental pediatrician.

And, there is always the possibility that medication does not work for your child. This happens more frequently with the inattentive type. Again, an expert can guide you and recommend alternative therapies and supports if needed.

So, to answer your question - is there another way to diagnose? It is a clinical diagnosis based usually on rating scales, cognitive test results, perhaps observation and interview. Unfortunately, no simple blood test or x-ray that gives a definitive yes or no! You can rule out certain "look alikes" such as sleep disorders, Lyme decease, thyroid problems, learning disabilities. But the diagnosis is primarily based on the physician's judgement of the data. Again - this is why using and expert is so helpful. ( I do think that testing that is only one year old should be sufficient - perhaps they could take a look at some specific new testing, but it seems crazy to retest the entire battery. In fact, many tests cannot be used more than once a year and most experts suggest that the WISC should be given no more than every 3 years if possible).

Both the psychologist and the pediatrician said that the results of meds are lesser with inattentive type. I'm not sure what the medical basis for that would be. Also, we were told that the primary risk of stunted growth arises from the decrease in appetite that can happen, and that it mainly happens when there is a significant decrease in appetite. We were lucky in that our DS12 is very very tall for his age so we were less concerned about that. When he went on the medication in the spring for the first time we did notice that he wasn't very hungry at lunch time. For several reasons he went off the meds for a time during the summer and interestingly, when he started the meds again in August, he was now hungry at lunch but less hungry at dinner. He's grown several inches since he started the meds and hasn't gained weight, but honestly, he was slightly chunky in the first place and has now just stretched out. But, in his case, he was still getting plenty of nutrition.

Medication is a huge decision and I think we all are hesitant to give our kids anything that they might not need. So, take your time and research it and just do your best. You always have to weight any potential benefits with any potention negatives.

Also, I wanted to say that we had heard anecdotal evidence that Omega-3 fish oil could be helpful and, since it couldn't hurt, we started our DS on this as well. It's hard to say, though, if we've seen a change due to this. But, it is one less-medical way some people try.

Thank you both for your suggestions. To clarify, we have no intent of retesting the WISC. The first time she was tested on the WISC (with the higher scores), she was 7.5. The second time, she was 8.5. She is now 10, so it's been about 1.5 yrs, but I, too, think that the data from those two testings should be sufficient.

We are looking more at whatever other type of testing would be done for ADHD. The BASQ rating scale was what the prior psych used at 8.5, but due to the reasons I mentioned I am hesitant to rely on subjective ratings by dh and her teacher(s). I can't reasonably ask them to look only at my ratings, though.

RE the appetite thing, I've heard that as well. That is part of what makes me hesitant about medication. Dd has a fairly poor appetite to start with. We can certainly try O-3 supplements, but they won't be fish oil b/c the whole family is strictly vegetarian. There are some vegan O-3 supplements that are algae derived and supposed to have DHA, though, so I can look into those.

Some ADHD meds will suppress appetite and lead to delayed (not stunted) growth. The children are supposed to grow to normal adult heights, just a little slower. If you decide medicine is the way to to for school, you don't have to use it over the summer. If you don't use it over the summer, she may do most of her growing over then. Some ADHD meds have been shown to suppress appetite for a short while after they're started, but the the appetite comes back.

My ds takes Vyvanse. He doesn't eat much in the morning, unless I get the food into him early. He eats a small lunch, but many times he eats a lot for dinner (when the medicine has worn off).

The non-stimulant ADHD meds (Strattera) do not suppress appetite and so far as I know do not interfere with growth. They are less effective for some kids but very good for others. I wouldn't rule out any treatment until talking with an expert.

DeeDee

Regarding the effectiveness of stimulant medication for ADHD-in: Russell Barkley has done some research in this area. He has found that lower doses of stimulant medication typically work better than higher doses. For those with "sluggish cognitive tempo" (SCT) - he believes is totally different condition from ADHD and patients often do not respond to stimulants.

I would suggest taking her to a child psychologist to get diagnosed. We went to one after DH *refused* to do a trial of meds prescribed by his ped. The first meeting, the psych could tell DS had ADHD, but did several tests and had his teacher and both of us parents fill out (separately) a questionnaire.

We went to the psych for over a month and started doing a token system for behavior. After MUCH reluctance we started a trial of Vyvanse (stimulant) at the lowest dose (20mg) because he's only 5 and is already very small for his age. We just made it through the first 30 days and the only side effect we've noticed is he's emotional (crying at everything) when the meds wear off in the afternoon. His appetite hasn't changed at all and his weight hasn't changed either.

We went back to the psych to get a reevaluation, he wanted to up the dosage (to 30mg) because he noticed a difference on the tests, but they still weren't "normal". So we got a new scrip for the 30mg yesterday. We'll start trying those tomorrow.

We were both VERY hesitant to do meds. I was never diagnosed with ADD/ADHD, but I know I have it. My parents refused to put me on Ritalin when I was little. I kind of wish they had done something though. I was mainly worried about the growth thing because DS is already small. So far he's doing fine though. The meds have made a big difference in his attitude and behavior though.

Thanks. Dh, like you, was not dx with ADHD as a child but we've had a counselor he saw as an adult tell us that he likely has it and he has classic symptoms. He is a very unhappy person who came out of school feeling like he was stupid. He still feels that way to this day.

If you know, what type of tests did the psych run for your ds other than behavior scales? Dd doesn't appear to have an attention issue to people who don't know her. She is quite an actress and is involved with theatre. She plays whatever role she thinks will put her in the best light. She'd sit there and appear to read or focus on something for an hour if that's what she thought would look "normal" to the psych. Granted, her mind wouldn't be focused but one can't tell that from looking at her.

I believe that she is quite bright and she's older so she can pull off the "typical" act well enough to fool most adults. She compensates like mad and saves the melt downs and obvious lack of focus for home where she asks for help and then cuts us off, cries, and interrupts herself and everyone else non-stop.

She did see a child psych for a few visits about 1.5 yrs ago and the only odd thing she noticed was that she had dd playing some game where dd was taking an unusual and somewhat ineffective approach. She showed dd how to do it and dd just kept trying her ineffective way over and over refusing to give up until she could make it work. That, however, may just be a personality (stubornness) issue more than anything.

I spoke with the in-network psych yesterday. She felt that, based upon what I was telling her, dd likely does have inattentive type ADHD and that she would be able to dx her based upon the prior data we have and talking with me and dd. However, she also felt that she wouldn't be as helpful to dd in dealing with it as would another local neuropsych who runs this place: http://www.neuro-development.com/

They, unfortunately, are out of network and our insurance won't pay for dd to see them. They said that it would be $135/session and approx 14 sessions to dx (6 for testing, 6 or 7 for writing up the treatment plan and dx and 1 for a parent meeting, I believe). Given that this works out to nearly $2K, I really don't think we can do that.

I left a msg back for the in network psych to see if we could at least get dd in to see her to see if she thinks a dx is warranted. This would be free in-network. From there, I guess that we could get medication prescribed by her pediatrician with the psych's dx, but I gather that treatment entails more than putting the kid on medication.

Thoughts?

I'd find out what specific tests the out of network person would do, and what their report typically includes.

What does in-network person say that out-of-network person can give you that in-network person can't give you? Is there an expertise gap?

$2k isn't out of line for an independent complete neuropsych workup, but I'd be tactical. If you don't need this report for treatment purposes (or school negotiations) moving forward, or if you can get what you need in network, why pay the premium?

On the other hand, some of the top of the line people are great at negotiating with schools and very usefully specific in their recommendations-- some will even come to school meetings and negotiate for you. If you need something to change and you haven't been able to make it change in other ways, it could be worth the 2k to you. Really depends on what you plan to solve using this information.

DeeDee

We just don't have that kind of $ without pulling it out of our home equity or dh's retirement savings right now.

From what I gather, he would be better able to ascertain what, neurologically, is causing the issue rather than just giving it a diagnosis. He would write up a detailed report on how best to address those deficits in a school setting and otherwise, but I was told not to expect the schools to implement any of his suggestions based upon what had been seen in the past with kids like dd who aren't performing below grade level.

The in network person would be able to give it a name and set us on the road to a prescription if we wanted. She can also provide counseling, but she isn't an expert in ADD. None of the in network providers they gave me are experts in ADD. The only local self-proclaimed experts are out of network. The specific one she recommended doesn't work with any insurance. He provides a bill that you can submit to your insurance and see if you can get reimbursed -- which would be a "no" in our instance.

Hello Cricket2...After much reluctance, we finally decided on 5mg adderall for DS10's inattentiveness. Its only been a few days, so I will let you know how it's working later So far so good. DS has all of the complexities of giftedness, so I waited (probably too long) not do the medication route. I still believe that a lot of his behavior DOES have something to do with his overexcitabilities, personality type, giftedness...We tried every natural alternative out there, read a zillion books... What finally made me decide to try medication was that we were at our wits end as a family and his grades were dropping- Not because he couldn't do the work, but because he would continually forget a pencil, notebook, workbook, forget to turn in assignments, forget to bring home assignments, etc...etc...Ugh, it was a mess. Our homelife started to become so chaotic because we were always bringing him back to school to get "whatever" ... To get through nightly homework, we started to focus so much of our time on DS. Our other children started to resent the situation, lots of tears...I was afraid if we didn't get his "executive functioning" skills under control, he would start to have serious underacheivement and self-esteem issues...And not get approval for subject acceleration. Going on medication is never an easy decision...So many unique situations with our unique kids! Good luck with everything

Cricket2 - I can't see spenting 2K for this, probably because I don't believe that the science is really firmly able to grant this as yet. And because it's a rare school that will provide this sort of accomidation for anyone who isn't failing or creating some kind of havoc.

There are tons of books on the market that list what the common difficulties that kids with ADD/ADHD tend to have. Browse around and see what appeals to you. Remember that you can only probably work on one stumbling block at a time anyway. Journaling to see what is bugging you the most is probably a good way to discover what the 'neurological weaknesses' are. I'd rather see 2K going to work with a good tutor or mentor who knows a lot about how gifted girls with ADD tend to slide though the system.

There are some kids who seems to do really well with medication right away, or after a few tries. Other families jump on the 'medication merry-go-round' for quite some time before finding a pill that makes their kid feel and act 'better.' Then other kids just seem miserable from whatever medication they try.

Meanwhile, non-medication approaches, such as strenghtening the overall EF of the family (flylady is one possible way), regular physical activity (trampoline and karate are favorites), sleep hygiene, healthy diet, super-parenting (such as 'Transforming the Difficult Child Workbook') or bio-feedback/heart-centered meditation (http://www.iamheart.org/ or http://store.heartmath.org/store.html)are usually needed even if the medication works well. Of course no one can do all these things at once!

Best Wishes,
Grinity

The T.O.V.A. is a computerized test, and it is often used with other assessments for a diagnosis.

Someone else suggested that same test on another discussion board and then another person posted this: http://www.adhdtesting.org/tova.htm

I'm not sure whether this computerized test or another computerized test would tell us anything or not .

That's kind of what I was thinking after I posted that. Is it really work $2K for better recommendations on what is going on and how to treat it? We can certainly start with a dx, meds, and other techniques at home. I did pick up a book at a used book store the other day that had some good suggestions including cutting apart comic strips and having the child rearrange them into the right order to deal with logic issues (or seeing things in a more convergent way). I don't want to do away with her divergence b/c I think that it is a real asset in some areas, but it would be good if she could get an idea of what the "typical" person might see in a question.

eta: What would you suggest from these product lines? There seems to be a lot of stuff there. I was imagining the coherence coach CD maybe: http://store.heartmath.org/cd-roms/coherence-coach-cd .

It sounds like there is more going on than just ADHD. I am thinking some executive functioning deficits that almost always accompany ADHD. Here are a couple of good resources:



Executive Function...
"What is this anyway?"
Chris A. Zeigler Dendy, M.S.
http://www.chrisdendy.com/executive.htm
Parents and teachers are often baffled when students with attention deficits, including those who are intellectually gifted, teeter on the brink of school failure. Recently researchers may have solved part of this challenging puzzle; deficits in critical cognitive skills, known as executive function, may interfere with a student's ability to succeed in school. Practically speaking, executive function deficits may cause problems for students with ADD or ADHD in several important areas: getting started and finishing work, remembering homework, memorizing facts, writing essays or reports, working math problems, being on time, controlling emotions, completing long-term projects, and planning for the future.

Executive function: A new lens for viewing your child
This theory of how we mentally navigate life offers a new way to view a child's strengths and struggles.
By Kristin Stanberry
http://www.greatschools.org/special...-lens-to-view-your-child.gs?content=1017

As each of us goes about daily life, numerous mental processes and skills help us plan for � and respond to � the tasks, challenges, and opportunities we face. Researchers and psychologists have coined the term executive function to describe this constellation of cognitive controls. The dynamics of executive function affect every one of us � young and old, as well as those with and without disabilities. It influences our performance at school, on the job, our emotional responses, personal relationships, and social skills. Yet executive function plays itself out a little differently in each of us; each individual is uniquely strong or competent in some cognitive control areas and weaker in others.


Based on the the neurodevelopment web site you posted - it seems that they are promising to help in these areas. While outside assistance may be great, as you've found it is expensive. I suggest you pursue these issue through the school first. In theory, if EF is what is causing so much trouble for your very bright child, they should teach the strategies to help her initiate, plan, organize and execute on her work so that her gifts are recognized.

How can you do this?

When you said she has been tested twice - was this by the school? Have you ever referred her for a special ed evaluation? If not, I would start with the school. If she has been evaluated already for special ed, you are entitled to an IEE (Independent Education Evaluation) by a credentialed independent evaluated of your choice paid for by the district. This professional can use diagnostic testing to help understand what is going on and what is needed to help your child. If your child qualifies for special ed (and doing well in school does not necessarily preclude one from sped), the school should provide the needed instruction to help your child be more efficient, productive and successful.

If she hasn't been evaluated by the district yet, their evaluation may be sufficient to shed light on what is going on. But, again, if you disagree with the results for any reason (ie they don't have comprehensive enough recommendations), you can then request an IEE.

Even if you find a medication that works, it doesn't magically provide the EF skills that are needed for success in school and life. They will simply make it easier for her to access instruction for the skills and will help her better remember to use the strategies.

As far as techniques at home - I like these two practical books:

"Late Lost and Unprepared"
"No Mind Left Behind"

Both prior assessments were done privately and paid for by us. The first one consisted solely of the WISC-IV and a brief report. The second was much more comprehensive but I can't say that I agree with the psych who did it in that she said: 1) dd does not have any LDs b/c her WIAT (achievement scores) were higher than expected per IQ, 2) she should not be placed in accelerated classes despite high IQ and individual achievement b/c she wants to be normal and it might make her feel like she stands out, and 3) she doesn't have ADD b/c her teacher's behavioral scale said that she didn't. She had no explanation for the wild achievement and ability fluctuation other than maybe dd was anxious and we were hothousing her (not in those words, but it came across that way). A negative comparison to her sister was also written into the report (along the lines of "she's smart, but doesn't appear to be as smart as her sister.")

I really, really doubt that the district would agree to evaluate her for special ed in that we have one independent pysch saying that she has no problem and she's not performing below grade level. In fact, she's in GT classes for both reading and math at this point.

I'm also not sure that an IEE or district eval would be any better than that which we can get free through our insurance. She has an apt with the in-network psych for next week.

That sounds like a lovely goal, Cricket2. I don't think you have to worry about damaging her divergence, because you aren't saying she is wrong, just that 'here's a good skill to have.' And believe me - it is a good skill.


Ok - now were are in murkey territory. I and totally enjoying my Heart Rhythm meditation - no electronics required - just sit nice and tall, listen for my pulse, and breath in and out to it's rhythm. I want to learn meditation and have access to all that world view. My neighbor is having a lot of trouble hearing her pulse, so she uses a stethescope, but it bothers her ears. So we've been looking around for a 'just give me the benifits and leave the philosopy out of it' way to do similar.

It seems the ebook - Teaching Children to Love - e-BookETCTL
Item # ETCTLPrice: $11.95
Might be a good place to start. But my guess is that sooner or later you are going to feel like you are reading an infomertial for their 200$ pulse monitor system. Please let me know if the HeartMath people have 'subtled up' since their Amazon reviews.

What my neighbor ended up buying is StressEraser Portable Biofeedback Device by StressEraser
Buy new: $134.50
Because you get to see the graph of the sin wave that shows you are getting the benifits.

The HeartMath people also have software games, but I think a hardware piece is needed to measure the pulse.

Bottom line - Slow Deep Breathing in time to the pulse - through meditation or biofeedback is starting to wrack up credible evidence to increase 'Heart Intelligence' - decrease stress, anxiety,sleeplessness and the ill effects of OverExcitability and increase consentration, general satisfaction. Please keep me informed if the HeartMath 'calvalcade of products' turn out to be helpful to anyone. Like anything else that's good for you - doing it regularly is the key to getting the benifits.

Love and More Love,
Grinity

If you request an evaluation from the school, they must evaluate in all areas of concern. They cannot refuse. They may not find her eligible for special ed - that is another issue. But, under IDEA (federal special ed law), the MUST evaluate in all areas of concern within about 60 days (varies by state - some states have shorter timeline).

The evaluations that you get from schools are often less diagnostic than private evaluations. But, they will give you a read on many areas of concern.

This is so sad. ((Hugs)) We got similarly 'off base' report from a local private eval we paid for too.
Grimity

Speaking as a parent who has done testing more than once, one could spend a lot of money and never receive a definitive diagnosis or receive conflicting diagnoses.

We saw a gifted expert, and we also saw someone who does other assessments, one of which is the T.O.V.A. The later definitely demonstrated what we were observing.

We then had conflicting assessments; for us it came down to trying interventions for ADHD and executive function. And in our case, it helped.

lightdance - I agree that if the situation is complex, evaluators often disagree on what the primary issues are and where to start with the treatment. I suggest more information because it seems like Cricket thinks there is more going on than just ADHD, and if there are other disabilities such as a language based learning disability such as dyslexia or dysgraphia, it would be important to recognize this and begin treatment in every area of need. And, if her child qualified for an IEP, this would afford the student accommodations and instruction in school. EF skills can and should be addressed by an IEP.

As far as ADHD, at some point it makes sense to take the plunge and begin treatment. I know in my son's case, once began treating with medication and a change of educational placement, life got a lot better for him.

How does one treat dyslexia if the child reads reasonably well? Dd's reading comprehension is well above grade level as is her decoding. She has some other issues with reading but I am wondering if her wandering mind might be enhancing them.

My mistake. I was using reading as an example, not suggesting that dyslexia is a problem. Poor choice on my part, an I am sorry for the confusion and the stress. I am sorry.

My point is that it seems you are concerned with issues that go beyond ADHD - perhaps EF difficulties? And if so, it is helpful to have data that can help shed some light. You are entitled to a school based evaluation which may give you the info you need, and might perhaps give you additional services to help in areas of need.

The other thing to consider is whether her reading is commensurate with her intellect. For instance, I've seen gifted kids (WISC in the 90 percentile or above), with reasonable reading decoding and fluency skills (at the 50 percentile). This difference between intellect and reading can cause havoc and sometimes points to a reading difficulty. However, sometimes it points to an attention issue. Sometimes both, sometimes nothing. The child needs to be looked at as the whole and hopefully, with the help of experts you can decide what needs support, what kind, and how it should be delivered. It's not an exact science, but information helps because things aren't always black and white.

Again, I was trying to point out that
1. The District MUST test
2. The school may be able to deliver supports
3. Sometimes the data shows co-morbid issues that may be contributing to the struggle.

Dyslexia was a bad choice of words on my part, and I'm sorry I made the conversation more confusing.

I've been thinking about this and I am not sure that I am concerned with things that go beyond ADD. She is a very divergent thinker, but I don't know that I'd call that an executive function difficulty or even a problem at all. It is certainly a hinderance when you are looking at a school based setting and tests that test convergent thinking, but is it really something wrong? I'm not sure that it is. I actually think that it is a real plus in life in some ways. It just isn't valued as much b/c it is atypical -- much the way being gifted is atypical and can make school challenging as well.

I'm not bothered that you suggested something more. Just in thinking about it, I am realizing that some of what makes life and school challenging for dd is just part of who she is as a person and things that I don't really think are pathological. I don't want to change those things.
No, her reading really doesn't seem to be commensurate with her ability. The two times she took the WISC, her VCI scores were in the 99.7th and 99th. Both times there were two scores in the 17-19 range and one much lower (12 one time and I can't recall the second). She is probably very, very able in the verbal realm. Her reading comprehension runs in the mid to upper 90s and sometimes lower on tests like MAPS, but she pretty consistently decodes extremely well and has very good comprehension (many grades above level). Her troubles with reading related to rate (speed) and distraction. She loses her place or stops part of the way through a sentence b/c she is thinking of something else. A lot of people with ADD with whom I have spoken have told me that they experience similar sx. There may be something more going on, but I think that we'll look at the attention issues first and then see if there appears to be more if that doesn't make a significant difference.
I am still going to private route b/c, as you said, it isn't an exact science and I've seen two experts look at the same data and come away with totally different diagnoses or none at all. I don't trust that the school is going to find anything. I'd rather go the route of someone I've selected myself.

I'll let you know where we wind up once we get through some of the meetings w/ the psych through our insurance.

Good luck! I hope you can find the answers that help.

Cricket, if I'm not mistaken, I don't think mich was telling you to NOT go the private route. But if you want the school to actually do something to help your DD, they *have* to (by law) do their own eval.

Now, their eval can be made to include information from your outside eval (if you hand over your privately acquired information and/or bring your experts to their meeting). But without their doing an eval, no services or accommodations are likely to be forthcoming. Especially not in a case like your DD's where she is not obviously failing.

Often it's advantageous to do both a private eval and the school eval concurrently. Since the school has 60 school days to get theirs done, it takes quite a while, by which time you'd likely have your outside results ready to deploy. If you wait until you have outside results to approach the school, you've likely lost any chance of getting help from the school during this school year, just because of the time it takes.

Best,
DeeDee

I was hoping that my prior response wasn't going to come across harshly and I'm sorry if I failed at that. We've actually had the schools implement things based solely on private evals. Dd12 had a 504 plan based on a private OT eval. No school evals were ever done.

I'll see what we come away with from the private eval and then see where we get with the school. I'm not sure what would be recommended for the school to do in the case of ADD anyway. Of course, that's not one we've dealt with with dd12, so I don't know. For her it was SPD and they implemented preferential seating away from noisy items and leaving the room for testing so she could test in a quieter environment without the distractions of the other students.

HI Cricket -
I actually think that private evaluations yield better diagnostic information and more compelling and complete evaluations. But as Dee Dee mentions, if you want any help from the school, they must do their own evaluation. So, to get the process started, it is often more timely to let the school give it a stab first. Plus, the district only needs to "consider" your private evaluation. This can mean anything from reading it, to burning it, to implementing parts or all of it! Of course, if the school evaluates first, they often have access to some of the "better" tests and this may limit the tests that the private evaluator can use since most tests can be given no more frequently than every 12 months. All in all, going private has some real advantages!

I did not feel that your response was harsh - no worries on this end! It's important to understand the pros and cons of various options. It sounds like getting a more complete diagnosis/understanding of your childs needs is more important than quickly getting services going in the school. I understand your reasoning!

I hope that you are able to gain important insight and direction from the evaluation - this is an important first step!

So, I spoke with the parent liason in the special ed office and here's what she told me:

* dd would not qualify for an IEP regardless of the dx b/c an IEP requires them to show significant educational impact which their office defines as a child performing below grade level. Even if it is a significant impact in that it is making it such that she isn't performing close to her own ability, she is too able to have an IEP b/c she is compensating well enough to never fall below grade level.

* dd could qualify for a 504. This does not require any testing from the school and, in fact, normally does not include any testing done by the school.

Essentially, what I was getting was that dd is too intelligent to have an IEP regardless of how significantly ADD (or whatever) is impacting her education. Thus, 2e kids don't get special ed services unless their disability is so huge that they perform below grade level. I'd gather from that that HG+ don't get IEPs.

I don't know that I need her to have an IEP. A 504 might be fine. I'm going to play it by ear for now and see what the private psych says before we decide what to do.

That doesn't correspond at all to my understanding of what is mandated by law. They are required to give each child an "appropriate" education; if her disability is hampering her learning, they are required to address it, no matter what level she is working at.

We were given this run-around by our district at one point, too, argued the point, and eventually received appropriate services for him. You might choose to do some reading on Wrightslaw.com about your DD's rights if you want to know more.


Whether this is appropriate depends on what your outside tester finds. A 504 will not include any direct services to remediate deficits, but it can include accommodations (more time on tests, changes in how instruction is delivered). If they find your DD needs specific kinds of training to improve her capacity to attend, that won't be covered in a 504.


Again, this is not an appropriate or legally correct position. Districts sometimes use this criterion to make less-informed parents simply go away and stop asking for services.

If your outside advisers name services that can improve your DD's educational experience in school, know that you don't have to accept the "grade level" argument, because it won't stand up to challenge.

DeeDee

Cricket, we were given the same interpretation of RTI for our kid. The school said that they would not qualify her for an IEP because she is at or above grade level in everything. They were willing to give her a 504 to allow her more time on tests (it was in their interest that she not totally bomb her CSAPs). When we presented our outside testing showing a large gap between achievement and IQ scores, they said that the achievement gap model is no longer recognized. I've reviewed the CDE's website and it seems to support this interpretation. Their interpretation of RTI only says that gifted kids who are high achievers need to be given more and kids who are failing need to be given more. If your kid tests as average, they don't seem to have to do anything. I haven't done any further research. I know other folks in CO who are getting the same story.

I was going to say that I was glad it wasn't just me, but I think that it would be better to say sorry that it isn't just me getting that story! I'll do some more research into it although I don't yet know that an IEP is what she needs.

We had our first meeting with the psych yesterday. She'd like to meet with dd for a few sessions before going further in deciding what is going on. She said that anxiety could look a lot like ADD and she wants to spend some time flushing that out before we try to ascertain if it is ADD.

We do, again, have behavior rating scales to fill out, though. I'm contemplating whether I want to have dd's GT teacher fill one out as well. She gave me the option of doing so or just filling them out myself.

She also mentioned considering redoing the IQ at some point although she hadn't initially thought that was necessary. Her thought was that the initial IQ done when she was 7.5 was likely more accurate b/c it was something called the WISC "integrated" which allowed them to look at scores both with and without the impact of timed parts. She thinks that processing speed may be creating an issue for dd. (PSI was low both times.) She also said that the psych who oversaw the doctoral student who tested dd that time is the head of the psych dept and very good and she doubts that he would have messed up. (He observed the testing and reviewed scoring.)

Her comment was that "typical gifted kids" get 15s and 16s on the WISC whereas dd had two 18s on VCI the first time and a 17 and a 19 the second (as well as a 18 on PRI and other high PRI scores the first time). She felt that it was possible, if she repeated her performance of the first test, or even the second with a slightly higher comp to go with the 19 & 17, she might qualify for some services for more HG kids outside of school.

We're holding off on redoing IQ partly b/c we have other things we need to spend $ on (car brakes, etc.) but also b/c I want to flush out what else is going on first.

I'll keep you updated.

Incidentally, could you point me to the place on the CDE's site where you found that so I could start my research? Thanks!

Here is the state RTI guide. http://www.cde.state.co.us/RtI/downloads/PDF/RtIGuide.pdf
The movement away from the discrepancy model (IQ vs. WJII) is on p. 35.

I haven't read this in awhile. From what I remember, for lower performing kids, everything is based on closing the achievement gap between expected baseline on their assessments and actual achievement. For all kids they want to see demonstrated growth so RTI is supposed to help gifted kids by monitoring growth over time (i.e. growth model data on CSAPs). They want to see a year's growth in a year's time.

The problem for my 2e kid is that she tests as above grade level in math, slightly above grade level in reading and at-grade level for writing. Consequently, she doesn't meet their criteria for remedial intervention. As for the growth criteria, as long as she is showing progress based on their assessments, there is no requirement for intervention. So if they assess her as a 50th percentile kid in writing and she shows growth commensurate with a 50th percentile kid, no action. They never look at why a kid with verbal IQ of 130 and a FSIQ of 149 is only performing in the 50th percentile on writing.

I've been doing a little digging around and, while I can't find anything on the CDE's website specifically stating that 2e kids don't get IEPs unless they are below grade level, I did find an interesting legal opinion on learning disabilities online's website in relation to gifted kids:

"...the prevailing interpretation of Section 504 and the Americans with Disabilities Act is that a person must be impaired in a major life activity when compared not only to their own potential, or when compared to the group against whom they are being evaluated or competing against, but in relation to the average person in the population as a whole.

Based on this interpretation, it is not enough to demonstrate that an individual is functioning below their potential. In order to qualify as a person with a disability entitled to the protections of Section 504 or the ADA, including test accommodations, the individual would need to demonstrate that their disabilities cause them to function in the relevant area below that of the average person."

http://www.ldonline.org/legalbriefs/c682/#33

That's actually kind of scary in that my older dd had a 504 for time and quiet testing environment even though she has never functioned below the average person. We exited the 504 in 6th grade and wrote the same accommodations into her ALP, but that interpretation seems to call into question the accommodations she has as well as those a lot other kids here are getting!

Cricket, I'd be inclined to look at this in terms of skills rather than academic achievement. IDEA says that schools must teach academics, but also "functional skills"-- which include paying attention, remembering where you put your papers, how to participate in groups, etc.

This is much broader than most people realize, because they're stuck on what achievement tests show. But the legal precedents are clear that "functional skills" are absolutely covered by IDEA, and if a student has deficient functional skills, that may qualify them for services even if their academic skills per se are not impaired. (You can search "functional" on the wrightslaw website to get some background on this.)

What this means is that if your DD is demonstrably lacking some functional skills, the school may be required to remediate them. Of course it helps if this shows on an achievement test, but if you have frustrated email from teachers about her spacing out or similar documentation, plus outside testing that shows deficits, you can argue that there are areas where functional skills are below those of her peers and require remediation.

Yes, this is a hard case to make for a gifted kid, but it can be done.

DeeDee

As we are continuing to work through this, dd's school situation seems to be getting worse. We do like the GT teacher and she has really tried to make school work for dd, but she is also very frustrated and dd is really stressing about the being part of the source of the teacher's frustration.

Dd had gotten As on all quizes and work thus far this quarter until the unit test came along. She would have had an A- on the test had she not made some attention to detail errors. For instance, forgetting to put "cm" or "cm2" on some units of measure and just putting the numbers without the units dropped her grade down a full 12%. She also misadded one column of numbers coming out with 371 instead of 372. When she then divided that by 4 to get a mean, she did the division correctly (decimals and all) but got the wrong mean b/c the # she was working off of (371) was one off. She really did understand the material and did well aside from these detail errors.

From what dd said, the teacher was angry with her and another child for not getting at least an 85% and told them that she really didn't want to make another test (she usually lets them try a make-up test if they didn't do great) and that they would have to come in during lunch and study a lot to show that they were committed to learning the material if they were going to make her do more work. Dd does know this material. She didn't miss much of anything that related to understanding the material. She made errors that related to attention to detail. Staying in at lunch to study the material isn't going to help with that.

Dd is terribly stressed b/c she feels like the teacher is angry with her and regrets letting her into the GT class. This grade is a very hard group of kids and about 20 of the 90 kids in the grade are in the GT class for reading and/or math. The older, high achievers dominate the needs of this class which makes it hard to not resent the gifted kids who require more work on the teacher's behalf.

I know that I have eaten up a bunch of this teacher's time earlier in the year as well and am afraid that bugging her yet again to discuss dd's anxiety about the situation will only irritate her and make her want dd not to be in her class more.

Sorry to repeatedly post on my own thread, but this situation is causing me a lot of anxiety as well b/c I know that dd is suffering and we really aren't doing right by her. We either pretend she isn't particularly able (ignore IQ and higher achievement) and place her in avg groupings where the work is so easy that her attn to detail, etc. doesn't matter b/c she can coast or we stress her out by putting her in a more appropriate academic situation where she will be somewhat challenged but where the other kids are competitive and most aren't like her either (plus her anxiety is worse).

Honestly, my strong inclination is to take her out and homeschool as I had initially planned @ the begining of the year. The major stumbling blocks to that are:

* I work p/t and she'd be home alone for approx. 20 hrs/wk and she hates being alone.
* If she isn't in school at the end of this year to take the MAPS and the district readiness assessment for math, she won't qualify for subject acceleration in math in middle school should we send her back to school.
* If we keep her out for part of middle school and then send her back in, say, 7th or 8th grade, she likely won't get into the school we'd want to choice her to. Our neighborhood school isn't bad, but there is another option that would work better for her and our family and the odds of getting in are a lot better if you apply in 6th grade (which we have for next year).

So, she's well placed (or at least, not placed where she's having to do work she can't deal with, but she makes slips.
But equally, what would be the point of making the teacher do the extra work? The educational motivation for allowing a repeat test, and the justification for the teacher to put the effort into writing and administering it, is surely to give everyone the assurance that the student now understands the material. The "vanity" aspect of allowing the student a higher mark is a different matter entirely, and far harder to use as a justification for using up the teacher's very limited time. I agree that it'd be pointless for your DD to have to restudy the material, but I also think it's unreasonable to expect the teacher to make up another test because of this. Your DD should just accept that she got a low mark because she didn't attend to detail, but she does understand the concepts. The next test on new material will do just as well as a repeat of this one for trying to attend to detail better.

So, the teacher's got a difficult job at the moment. It sounds as though she isn't handling it too well, but we're all human... Can you meet her where she is by presenting her with the problem and a solution at the same time, and maybe doing it in writing rather than by a meeting so she can just say "Great!". My - bossy, feel free to take anything useful and leave the rest! - suggestion would be:

- DD accepts that she'll lose marks for lack of attention to detail

- and doesn't expect the teacher to do extra work to get round that

- but would appreciate clear feedback on why she's losing marks so that she can tell the difference between her ongoing attention issues and conceptual misunderstandings (I'm not clear on whether she's getting clear feedback at the moment, obviously you word this differently, depending).

- You tell the teacher that you're aware that your DD is having trouble avoiding slips, that you're not sure what's behind it, but that you're confident it isn't simple lack of willingness on your DD's part.

- She commits to working on it at home and you commit to helping her. For example, you could set her simple tests at home - a few questions requiring a bit of addition, with answers given in different units that need to be written in, or whatever - the idea being to incorporate practice at noticing whatever she hasn't been noticing, but in a context where that attention to detail is the only hard thing.

- Anything else you can think of. For example, would it help your DD to have a business-card-sized checklist of her common mistakes, e.g. "Have I answered all the questions? Does every question that needs units have the right units?" etc. My DS has one of these to remind him what to do when he gets stuck, and it really seems to help. Maybe the teacher would be agreeable to allowing your DD (or, anyone who wanted one) to have one in front of her when she does tests? You could offer to provide a stack...

I'm also not meaning in any way to dissuade you from anything you're doing to seek a diagnosis if one is applicable.

Thanks for your thoughts. Dd isn't the only child who got a C on this test, but she was mortified by the teacher making an announcement to the class that the grades ranged from As to Cs with a pointed look @ dd and another child and then sighing and saying that she didn't want to make another test and that they were going to need to show her that they were really willing to work hard by coming in at lunch to relearn the material if they wanted to retake it.

I, too, told dd that she might have to be willing to accept some lower grades as we figure out this attention to detail issue she is having. Her bigger anxiety is being caused by feeling like the stupid kid in the class b/c she is getting lower grades on tests than most of the other kids and feeling like the teacher is angry with her and resenting her.

Last night she was up an hour past her normal bedtime sobbing and telling me that she just wants to get As and be like dd12. Again, I know that she can get As in the non-GT classes b/c the work is so easy for her, but b/c this school has about 40% of the kids in accelerated math with maybe 15% in the more accelerated GT math (the one dd is in), it leaves the avg math class with kids who are below avg. That was the class she was going to be placed in in lieu of the GT math b/c they didn't have enough room in the accelerated-non GT math. I don't know that placing her with avg-below avg kids in order to ensure that she can get As is going to make her feel good either. She was pretty upset about that placement at the start of the year.

We have been working on this. She actually got a 100% on the practice test in class which, presumably, required attention to detail as well. She just has such huge anxiety related to the real tests at this point, b/c she hasn't done well on any of them, that it seems to be making the attention to detail much worse. Unfortunately, the practice test doesn't count toward her grade.

Can you help her care less about her grade? What matters is what she's learning, and that's the attitude she's going to need through life (even when grades may affect college entrance, which isn't yet, right?) If the teacher/the school is going to deny her appropriate education on the basis of grades that are pulled down by these issues, more fool them and you need to address it, but even then, it shouldn't be her concern, IMHO.

We're working on that too. The reality is that she is going to be denied GT or accelerated services based upon her grades/test scores. Both local districts base placement in GT or accelerated classes on achievement moreso than ability.

I'm really torn. Part of me says to just deemphasize academics and intelligence and just make like she is an average kid. Place her in the average classes and don't worry about the fact that huge #s of kids who are less able than she are doing well in the accelerated classes. If she didn't have an older sister who was such a high achiever, I think that might be okay. I don't know if it is preferable to what she's going through right now, though.

Do you think that putting a gifted or maybe HG+ kid in average classes and pretending she isn't gifted is reasonable in any circumstance if she performs better there?

Ouch. No, I don't - but it's the "pretending she isn't gifted" bit that makes me react that way, and my guess is that you wouldn't actually do any such thing (even if the school did). If she were happy in average classes *and* were getting appropriate intellectual stimulation outside school, I would think that was OK. It does seem ridiculous, though.

I've heard that ADD is less 'sure-fire' helped by stimulents than ADHD, too, but that's far from saying that the stimulents don't help any kid with ADD alone. My son has the inattentive type, and loves, loves, loves the way the stimulents make his brain feel. I hate the idea of medicating kids, but when we finally got him placed in classrooms that were interesting and he was still zoning out, he let me know loud and clear that he didn't want to be a victim of my political beliefs.

I think that your DD 'knows' deep down, that she is just as smart as her older sister, and when the teacher acts upset, it confirms your DD's suspicion that she has been 'cheated' in some way - and she has. I think it's time to try the medication and find out for yourselves if your DD can be more of the kid she knows herself to be on the inside, on the outside. Of course the medication isn't enough. And of course, the medication merry-go-round to try several different varieties is a big pain in the xxxxx. But she is feeling the pressure internally and there is real pressure externally. This makes it worth it to give drugs a chance and see if they suit her.

Also - starting the medications gives you a chance to sit down with Ms. Mathteacher, show how the errors on the test were 'attentional' not 'conceptual' in nature, and tell that you are starting the medication merry go round and that getting things sorted out may take a while. This will cut out the nasty looks at least for a while.

Just my .02 BTDT
Grinity

Thanks. The psych she's seen just once so far isn't convinced that it is ADD, though, so I don't think we are going to get a dx and meds for some time if that's what it is. She feels that anxiety is just as likely. Dd has her next appointment on the 16th, I believe. We'll see what we get from that.

Where I am so torn is that she sees placement in non-GT classes as proof that she is the slow one in the family. We haven't found a way to support her belief in herself as able and intelligent in either set-up. She makes too many simple errors to get As in the GT classes and she feels stupid in the regular classes b/c her sister was in GT and skipped a grade and, since nearly a quarter of the school is in GT, the kids in the regular ed are often so far in a different direction than she is that she doesn't really find any friends. She then identifies herself as slow b/c she must be in her mind since this is who the school thinks she belongs with. Unfortunately, she also winds up being rejected by the kids in GT b/c she isn't one of them.

They actually are in different schools and have been for the past three years. Her older sister did attend the elementary dd10 is attending for one year only (4th grade) before skipping 5th. We are planning to send dd10 to a different middle school than her sister attended as well.

She definitely has sister shadow issues in her mind.

Is there a way you can convey the information you are posting here to the psych? I respect that the psych isn't just rushing into the ADHD diagnosis.
In a way, your younger DD would be better off in a school that didn't have a gifted program. Are there any around? My son's district just offers Heterogeneous classes until High School.
I'd still try to talk to the Math Teacher and make it sound like the medication is coming 'any day now' to try and get the teacher to treat your daughter more kindly.

Best Wishes,
Grinity

I've been communicating w/ the GT teacher via email and here's the game plan for now:

Dd is going to go in before school the next time they have a math test and start the test early skipping page one. She'll then put the test in her folder and when they are handed out in class since page one is still blank hopefully it won't be obvious to the other kids that she has already started. We're hoping that this extra time will allow dd to review her work, re-read directions, and generally make sure that she hasn't overlooked anything. Testing alone for part of the test might also be good in terms of anxiety. The teacher will, of course, be in the room correcting papers or setting up, but I think that dd likes her well enough that hopefully she'll be calmer.

The teacher does agree that dd seems to understand the material better than she's showing on most of the tests. I'm not sure that she sees dd as as able in math as I do, but that isn't a big deal I guess. I just see a real creativity and artistry to how she approaches math and an ability to make leaps without needing the intermediary steps. The other kids in the class, undoubtably, have facts, etc. down better in that for most of them this is their third year subject accelerating and it is dd's first. I don't see memorization of facts and formulas as a real talent, though.

In re to schools with no GT groupings, I don't know of any around here. GT is a big thing with a lot of kids in GT at most, if not all, of the schools. I think that the only way to avoid that would be to go to one of the lower income parts of town which would be quite a haul and they would still have GT and ability grouping, but it wouldn't be as big in that there aren't as many well off, pushy parents tutoring their kids to get them ided as gifted. I do think that dd would likely be at the head of the class at the few schools I can think of like this, but I also think that the quality of education would be lesser.

We went in for another meeting w/ the counselor today. We're running into what we always do -- dd is nearly silent while there, snows the person by saying what she perceives to be the right response, and then comes out of there and says something totally different to me. Dd doesn't think that this is helpful at all which leaves me wondering if it is worth pulling her out of school to do.

There are very few afterschool apts available, so it usually involves sending her in 1.5 hrs late or pulling her out in the middle of the day. Dd also doesn't want her school to know why she is leaving or coming in late, so we're left making up excuses like a lot of dr or dentist apts.

I really don't know what to do at this point. They psych doesn't feel that dd has executive funtion problems. She thinks that dd is very abstract and perhaps is developing in such a way to to have skipped over the concrete stage that usually precedes abstract thinking so we're having to go backward trying to teach her how to think concretely. I'm gathering that she doesn't think there is much, if anything wrong w/ dd that needs treatment beyond anxiety and lack of confidence related to school and life not being a good fit for who she is.

So, our options are:

* continue to see the counselor and have her give dd ideas like positive affirmations/self talk which dd blows off and feels condescended to about.
* re-test IQ and see if she qualifies for something like DYS since her first set of IQ scores would have, but she's going to have to step up to the plate on achievement if so.
* drop this all and just let the chips fall where they may assuming that GT classes, etc. probably aren't going to be in dd's long-term school picture due to her erratic performance.

I missed the post about the math test idea - I really love the sensitivity the teacher is showing. I hate that Math is 'a race' when it's such a great time to teach kids to work 'slowly and steadily' - good for the teacher.

It sounds like it's time to start shopping for a different counselor, maybe one that will play chess with DD and watch how DD handles tiny bits of real life. Asking a child to be reflective is asking an awful lot.

Best Wishes,
Grinity

What would be a reasonable thing for a counselor to do with a 10 yr old then that would help with anxiety and not fitting in at school?

We tried CBT with dd12 when she was 8 b/c she was being bullied and had a lot of anxiety. She felt the same way about it that dd10 does about her current therapy -- like she was being talked down to and asked to "visualize" things that she felt were foolish.

So, here's the latest update:

We had another counselor mtg today & then dd stayed home from school for the rest of the day b/c she has a bad cold.

The psych thinks that dd does seem to show some signs of inattentive type ADHD given my behavior forms and the fact that dd stares off into space when she isn't interested in the conversations they are having and just kind of checks out mentally. She is concerned that stimulant meds might increase anxiety, though, and that they might be less effective for inattentive ADD than they would for hyperactivity. Her thoughts are:

* we can just wait for her frontal lobes to mature and her to grow out of the attention wandering and in the mean time work with dd on working really hard to focus when she finds herself mentally disengaging;
* we can try non-stimulant meds (dd didn't seem too sold on the idea of meds after this conversation);
* we can see how the extra time on math tests works and, if it seems to be a real benefit, she can write a dx of ADD that we can use to get a 504 plan so she can officially have that accommodation written into a legal document that a school will have to follow;
* we can re-test IQ and hope that dd repeats the performance of 2.5 yrs ago where she was in the 99.9th+ and apply for DYS (although I don't know what they could do for her to make school work better).

She is going to take the EXPLORE so, if those scores actually come back at the DYS level, the idea of re-doing IQ would make more sense. I'm also inclined to go the route of the 504 if the extra time really seems to make a significant difference.

In regard to meds, I don't know at this point. Since dd isn't sold on it, I'm not sure if I am going to push her, though.

I'm reviving my old thread to ask for input regarding some upcoming school meetings I have. The counselor wrote a ltr stating that dd has ADD and Anxiety Disorder NOS. I will be meeting with the school counselor re a 504 and the GT teacher re testing in math.

Dd continues to overlook pieces of directions and has lowered her grade one full letter grade on every test I've seen due to this (loses enough points for not doing part of the directions to bring it down from a B to a C, for instance). The last one entailed a whole page of ?s that asked her to list the factors for a set of numbers and then state the GCF. She wrote down the correct GCF for all but one of the numbers but didn't list any of the other factors, losing a significant # of points.

She also hasn't tried any of the extra credit questions b/c she isn't sure she knows how to do them. She does the same with other questions where she isn't sure -- she's just left some of them blank or skips over them to come back to them and then forgets to go back and do them.

The study guides that come home for the tests also don't generally correlate very well with what is on the test, so it is hard to know what she should be studying for. There was one question on the last test where dd's written explanation was apparently wrong & the teacher made a note that she told them it would be on the test and told them what to write, but dd wrote something totally different. (Maybe not paying attn in class??)

What would you ask for in terms of testing accommodations or other? I really do believe that dd knows this material a lot better than her test scores indicate but I don't know if the teacher will agree with that or not.

From what I've seen, she isn't asking for help much on homework and she has an A+ on homework & classwork, but that only counts for 10% of her grade. The quizes are worth another 10% (her grades on those fluctuate wildly, but avg out to about a B) and tests (her worst score) count for 80%.

She ran around 98% correct consistently on EPGY when she was doing it w/out my help but, again, the EPGY guy reads all of the directions out loud to you and it often says "give it another try" when you make stupid simple errors so it isn't one wrong answer and your score goes down.

If she stares off into space and "checks out" mentally, has she been evaluated for absence seizures?

No, but she's still present in a way, just not paying attention to what we might want her paying attention to. For instance, in the counselor's office, we (me, dd, and counselor) were discussing something and dd just started looking at pictures on the wall and no longer participating in the conversation.

Just FYI. I know you don't like the thought of meds-- I suspect nobody does. My DS8 takes Strattera for this kind of checking-out attention issue, and it has vastly improved his ability to stay tuned in at school, remember instructions, and get jobs done. It's not a cure-all, but effective.

DeeDee

I'm not totally opposed to meds. The psych just didn't seem to think they were a good idea due to dd's anxiety, size, and that she didn't feel they'd be terribly effective for inattentive ADD.

If small size is an issue, stimulant meds are probably a bad idea. Strattera is in the other class of ADHD meds, non-stimulant, and does not affect appetite or growth. It also has a small effect in diminishing anxiety.

Just giving you more to think about... not pushing.

DeeDee

No, I appreciate it; thanks. Did you find that your dc had to take the non-stim meds for a long time for any impact to be seen? Is Strattera a pill to swallow?

I tried getting her to take an algae based DHA (O-3 fatty acid) but she has a serious gag reflex issue that I'm pretty sure is psychological. We couldn't even get one pill down her and it was small -- about half the size of a vitamin-E capsule. We put it in pudding, had her try to swallow it with juice, etc. She wretched and made horrible gagging noises.

Dd turned 10 this fall and is 4'4" tall and weighs 56 lbs. We, obviously, don't want to stunt her growth, but dh is only 5'6" and a lot of my family is small as well, so it may just be her genetic potential.

Strattera is a pill to swallow; our dose is a standard size capsule, which may be hard for some kids. I don't know whether it is available as a liquid alternative; many meds for kids in this age group are. I also don't know whether you're allowed to break open the capsule; it's long acting, so I suspect probably not.

For swallowing practice we started our DS on mini-M&Ms with a big wash of apple juice afterward, and he hasn't had trouble with pills.

Strattera has much less of a "WOW the kid is different now" impact than the stimulant ADHD meds do. We did start to notice subtle changes right away, and a cumulative effect within a week or so. The child actually remembers things now... such as his homework! But no effect on appetite or growth.

For us it's a real help. We do find we have to be consistent about giving it at the same time each day, but that's a worthwhile investment.

DeeDee

My DS does this quite alot. He will often put down the final anwser but not show the steps that were asked for. He also sometimes forgets to answer questions or parts of questions.

I don't know what your DDs math tests look like, but I find my DSs tests are often visually distracting with little pictures, different sized fonts and unequal spacing between questions -- I'm pretty sure he would do better with a plainer, easier to read page layout with a really obvious place to put each answer. Also, would the teacher be willing to read over the questions with your DD 5 minutes before the test to make sure she knows what is being asked for (ie "in this question, you need to write down ALL the factors, and then write the GCF)?