Gifted Issues Discussion homepage Forums Twice Exceptional ADHD and/or Dysgraphia - Med question

So my ds9 is probably my most gifted child - possibly in the Exceptional range. (The oldest 3 have all participated in Duke TIP).

But while his verbal skills, oral reading, and reading comprehension are very high, he has always had a problem with written work. He did not like to cut or color as a preschooler.

Pushed by the school, we tried Concerta, and that helped, for the first few days. After that it was back to the same problems. Upped the dose, again, a brief improvement, and then back to same problems, and after a month, he developed a tic.

Switched to Stratera - same story. If he is off the drug for a while, the first day or two back on show an improvement in focus and completing written work, but only for a few days. Again, pushed by the school, we tried an increased dose, same result.

At this point I have to wonder about the accuracy of the ADHD diagnosis. He has never been disruptive in class, but simply didn't get the written work done at the rate others did. The phrase from the teacher at that time was "We know he knows the subject, but he has to write it down."

If ADHD was the major component of his problem, wouldn't there be a more lasting effect from the meds?

If instead, he has dysgraphia, could that be behind the problem?

When we were evaluating him in 1st grade, the OT recommended services, but since his achievement testing was average, they said he wasn't eligible. They never did actual IQ testing, although every teacher he has had agrees that he is gifted.

He is also extremely small for his age - in the 0.3 percentile for weight, and we are under evaluation for possibly starting Growth Hormone.

You can see why I'm hesitant to give him the ADHD drugs if they aren't working.

Anyone have experience with this issue? Do we just need to keep trying different drugs? We have a Dr. appt Mon for the med evaluation, and then a meeting with the school. I want to request testing, accomodations, etc, and could use advice on specific phrases I should use.

Who is your prescribing physician? Is it a specialist in ADHD and learning disabilities, or a pediatrician? I would only use a specialist for med management, and I would only try further drugs after testing to tease out what specific issues are present.

DeeDee

I am going through something similar with my son (3rd grade). I became very frustrated with the school blaming his very poor writing skills on ADHD (he is inattentive in class and not hyper or impulsive), so I took him for a private evaluation. I will find out the results next week. During our initial interview, the psychologist looked over my son's work and was surprised that the school had never mentioned that he could be dyslexic and dysgraphic. The types of mistakes that are evident in my son's writing point towards dysgraphia. He also skips words when he reads and makes many mistakes when he copies. Watch the Eides' video on YouTube called "What Does Dyslexia Look Like in the Gifted Child?" Good luck! I recommend private testing. I feel like I should have done this a year or two ago.

As a mom of a child with ADHD, dysgraphia and dyslexia, I agree with all those that recommend further psycho-educational or neuropsychological evaluation. It could be ADHD along with other LD's or it could be stand alone LD. If so, specialized instruction and accommodation would be in order - with or without meeds, depending upon whether or not the ADHD diagnosis stands.

I also agree that for complex kids, a pediatrician may not have the expertise needed to help you treat/manage ADHD if it exists. I would recommend a developmental pediatrician, psychiatrist or neurologist that has expertise in LD's to help guide you. They'll be better able to tease out what is playing havoc with your son.

Also keep in mind that if you are in a public school, they do not have to accept outside testing. The law says they only must "consider" it. Most likely, they will do their own evaluation to determine if he is eligible for accommodations and services under special ed. Given he is so bright, they may be reluctant to qualify him. You may want to consider a strategy of letting the school do the initial evaluation and if you want more info and disagree with their results, you could then have private testing done. To get the school testing started, write a letter that explains your concerns and very clearly and directly request a full academic and psychological evaluation to test for the presence of learning disabilities particularly in the area of written expression. Under the law, they must conduct the testing within 60 days or so (varies by state), present you with the report, and determine if he is eligible for special education.

Best of luck.