Hi everyone!

My DS 11 yo shows signs of ADD - very forgetful, very slow to do tasks/chores, procrastinates, doing homework in a timely way is an every day struggle, argumentative. He seems overwhelmed by tasks so I have been breaking them down for him and this seems to help.

However, after a neuro - psych eval, he was not diagnosed with ADD, but instead anxiety and symptoms of OCD. Still, I believe there is some ADD and I wanted to see if by looking at his WISC-IV scores - there might be some clues.

Another issue that seems to get him is timed tests. He absolutely chokes on them, especially if it is on challenging content. He did not get into an advanced math course because of his low score and so I am wondering if an IEP might be in order for him. He very clearly can do the work - it's the testing that seems to mess him up.

He is a straight A student at a "gifted" school. However, I believe he should be accelerated as he does not seem challenged and hasn't been his entire school career. The test thing however is posing an issue to acceleration.

Here are his WISC-IV scores:
Verbal Comprehension Index SS=142
Similarities SS=16
Vocabulary SS=18
Comprehension SS=17

Perceptual Reasoning Index SS=131
Block Design SS=13
Picture Concepts SS=16
Matrix Reasoning SS=16

Working Memory Index SS=116
Digit Span SS=12
Letter Number Sequencing SS=14

Processing Speed Index SS=121
Coding SS=13
Symbol Search SS=14

Also, as a note he did not reach the ceiling on multiple subtests on the WISC-IV. It is possible that if there had been more questions, he would have answered them correctly and would have achieved a higher score.

I would really appreciate any insights you may offer.

ADD is usually diagnosed through a behavioral checklist that both parents and teachers complete. You describe some of the attributes of ADD in your DS but his test scores don't present a typical ADD/ADHD profile. These kids usually test low in working memory and especially in processing speed. The scores I have usually seen are right around the average range (100) or slightly below. Your DS has well above average WM and PSI in the superior range.

Your DS' WISC scores do not match the typical ADD/ADHD profile. Generally undiagnosed ADD kids are also struggling academically and not achieving straight As. Neither of my kids have OCD and anxiety but is it possible that perfectionism and anxiety could be causing the task resistance and difficulty with timed tests you describe?

That's the limit of the light I can shed on this. Other parents who face OCD and anxiety will hopefully respond and give you more insight on those challenges.

Agree that those scores don't show the lower processing speed and possibly working memory that I understand are among the hallmarks of ADD.

Thanks for your comments. He really is a perfectionist - that's for sure. The Connor evaluations from the teachers did not reflect ADD - that's why diagnosis was not made. However, the therapist who is working with him on his anxiety has seen his forgetfulness first hand and thinks ADD might be a culprit. I thought there might be some clues in the WISC results but I see that is not the case.

I am reading up on perfectionism...

Coco, fwiw, my ds seems forgetful, is slow to do tasks, seems to procrastinate, takes a lot of time to complete his homework even though he understands the concepts and has the answers, and is very disorganized. Like your ds, it helps tremendously to break things down into steps to keep him on track and organized. He also was held back in math at one point due to inability to perform quickly on timed math tests - but the best thing we ever did for him was to switch him to a school that put him where he was able to be challenged in concepts and skip over the whole timed-math-requirement. He is great at math, just not very fast!

Anyway, the reason I described my ds to you here is that he *doesn't* have ADHD - he has Developmental Coordination Disorder. I don't necessarily think your ds has DCD, but in the course of advocating for our ds we've come across professionals who thought he had ADHD as well as being on the autism spectrum. Our neuropsychologist has a chart which shows how many of the symptoms of each of these diagnoses (including ODD and others) overlap - and that's why it takes a professional such as a neuropsych or developmental ped who understands how to look at a wide variety of clues in tests and behaviors before making a diagnosis.

It can all be *extremely* confusing!

Best wishes,

polarbear

ps - re the WISC scores, my ds has a significant discrepancy in processing speed vs the other subtest scores - much higher than the discrepancy your ds has. However, I've read that any discrepancy greater than 1.5 SD might be significant.

Re the timed tests, rather than an IEP (which is used when students need individualized instruction) it sounds like your ds would benefit from a 504 plan and an accommodation of extended time on tests - this is a fairly routine accommodation if you can show a need for it, and I think an ODD diagnosis combined with evidence from prior testing that he is answering questions correctly but running out of time would qualify as a need. Extended time is (at least here) one of the *easiest* accommodations to get.

It seems to make sense that a child with an anxiety diagnosis might struggle with timed tests.

How long does it take him to do a similar test if you don't tell him it's timed? For my DD, until she could get used to it, we worked on timing how long it took to do the math fluency practice, instead of telling her it had to be in a given amount of time. That was enough release from the pressure to learn that she could actually do it.

Look around on the board for multiple threads on how math acceleration shouldn't hinge on doing the timed math tests.

I agree with polarbear that following up the evaluation with a request for a 504 for extended time or similar accommodation would be appropriate.

Thanks Polarbear. After your post I looked up Developmental Coordination Disorder and don't believe that is the issue (thought I'd try :)). But the 504 plan may be a good route. After speaking with an asst principal at the school this summer, she wasn't supportive, but I can keep pushing.

I will need to get the evidence from prior testing as you say. Thanks again for your help. And a shout out to fwtxmom and keerby. Thank you for weighing in on the ADD aspect.

thanks! I like the idea of relieving the anxiety via practice as you did with your DD. Will have to try.

Hope it helps. We've actually done two different things to deal with the issues of fluency and anxiety.

Initially I had her do the page where I was secretly timing her. After three days of that, I showed her the times. She then did the practice for another couple of days knowing she was being timed until the time got down to where it needed to be.

That instance I think was 100% anxiety.

When she was memorizing the multiplication facts and she needed to memorize them instead of working them out each time, we dealt with the associated anxiety by just counting how many she could do in 5 minutes, making the goal of increasing the number in that time. It was an interesting process, where we'd see her drop WAY down (like by half) about once a week, only to be followed by jumping up 20% over where she's been previously the next day. Dealing with the anxiety and perfectionism was really tough on those days where she dropped way down. After we saw that happen a few times, though, we noted the pattern, then I'd start to celebrate the big dips, saying "Wow, tomorrow's going to be AWESOME." We made several assertions that this must be some sort of rewiring leading to this effect.

As someone around her was saying recently: Brains are weird.

I can't figure out how to search this out on this forum or google for that matter. Any leads? Thanks!