Hi all, we were just in to talk to the staff at my son's school today about some of the issues going on right now with him. He is 6 diagnosed at different points with ADHD, ASD, anxiety, and Tourette's. Out of all of that we feel ADHD and Tourette's are most accurate/reflect what we see. He is taking a stimulant med in the morning and a dose at school over lunch period.

At the meeting today we determined that his most difficult times are times when writing is required and in art class, especially when they are supposed to color/draw. Today they did a stamping project and he was doing just fine. Both art and writing are also around the time when his meds are wearing off for the am dose. He also is reported to have a difficult time at group reading. We all agree that he seems to have good fine motor skills and that he is able to form the answers and even write them down. But he is extremely resistant to doing so.

He loves coding class and math and spends the majority of those classes on task (they are also at better times for his medication), but he is reported to be on task less than 10% of the time in writing class and to rarely comply with teacher directives at that time. He is often out of his seat. When I homeschooled over the summer I found writing to be extremely non-preferred as well. I usually allowed him to dictate after completing one sentence on his own.

His actual writing looks pretty good. He writes slowly and often misses words, but squeezes them in at the end when he notices the sentence doesn't make sense. Usually small connecting words like and, to, the, etc. He writes the bare minimum to answer the question, but gives much better oral answers.

He has been tested in the past for fine motor issues on various tests. He generally does quite well. When tested with the BOT II a year and a half ago (most recent test) he scored above average on fine motor precision and manual dexterity and scored well above average on fine motor integration. He scored well below average with a raw score of 0 on upper limb coordination. He also can't tie his shoes, ride a bike, catch a ball, pump the swing, etc. He isn't great at running/jumping. He is wonderful at climbing and balance IMO (based on the fact that he's always on top of the equipment at the playgrounds or at the top of trees.) He rarely falls or appears clumsy. He does look out of place with kids his age on a playground. He lacks the ease of movement/smoothness/speed other kids have developed. He is strong and can do the monkey bars if I help him with the swinging and, like I said, he's a great climber.

So, we are trying to figure out if he's just being difficult with a non-preferred activity, if he can't focus enough at that time when he's at the tail end of his meds, or if there might be a disability based reason for his trouble with these subjects. The teacher's all note his excellent fine motor when using small items to create intricate patterns for instance. They said he makes beautiful patterns and is able to focus very well. He is very particular and places the pieces perfectly.

Oh, and another issue. He is super competitive with his classmates. So we wonder if there could also be a competitive element. He is upset when they do their handwriting books because he's behind the other kids. Most of the reason he is behind the other kids is because he's off task so much, often concerning himself with the fact that they are ahead of him instead of working to catch up. He's ending up in the office most days and ends up spiraling and has a hard time reintegrating with class. This leads into his unmedicated period over lunch and recess and then he seems to calm down and re-enter class in the afternoon. He loves his school and most of his other classes. He reports enjoying language, music, math, coding, lunch, recess, and social studies. He also doesn't like gym.

Any suggestions would be greatly appreciated. The school has agreed to try giving him his writing work earlier in the day and giving him a free period at writing time if he gets it done early. This should help us tease out if the meds are involved. We all think that it's a bit more than that. He is so resistant to writing at home as well. It's always "You write it mommy," even for little notes and even when he in on his meds. Just a part of the basic difficulties of ADHD? A motor issue? Something else? Please help

Hi SaturnFan. Has your son been evaluated by an Occupational Therapist for Developmental Coordination Disorder? My five-year old son was evaluated last June and found to be within the range of motor skills to meet the definition. He is a bit young to tell yet whether he will have significant problems with writing -- he loves to draw and "write" things but his work is often quite messy. At the moment the DCD shows up most of all in his gross motor skills. He struggles with catching a ball, balancing, and climbing but he is a good runner. He has been enrolled in karate for the last 10 months or so and that has helped. Here is a link to a Canadian website about DCD: https://canchild.ca/en/diagnoses/developmental-coordination-disorder

My DS8 was diagnosed first with DCD and then with ADHD - there is apparently quite a lot of kids with both. DS also struggles with coloring and art class - I expect it's hard, and not very engaging, therefore he has trouble focusing on the task. Therefore he is slow at it, which increases the frustration...

His writing is also very slow - he does much better typing his answers on a computer. We are in the process of having the school get him his own Chromebook.

If DS has to do handwriting, I often scribe for him if it's more than a few words. Maybe ask your DS's teachers if that would be OK for homework?

Thank you for your ideas so far. I have a cousin with DCD, so maybe it's hidden in the genes somewhere? I guess my main issue with DCD is I don't feel DS is particularly clumsy. He doesn't trip or fall or bump into things. He does drop his pencil a lot though. And I totally forgot, but he writes a lot of numbers and a few letters backwards as well as from bottom to top. He doesn't know left from right either. Everyone agrees his handwriting is neat for his age, but that he does write quite slowly.

Luckily our school does not have any homework, so I don't have to deal with any of this myself. It's just that behavior is always a problem with DS and since it is so much worse during reading, writing, art, and gym activities I want to make sure there is nothing going on that we can work on outside of school therapy wise. It's so hard to tell sometimes what is a result of adhd, a possible unknown disability, or just poor behavior.

Most of his poor classroom behavior is extreme silliness or escape behaviors such as hiding under his desk or running out of the classroom. It's the extreme silliness that gets him sent to the office due to the level of disruption it causes the class. I just want to make sure that we are helping him as much as we should to do his best, no more and no less. It's so hard to set expectations when his neurology is still such a mystery

With a young child, I really do believe such a high level of resistance to a specific task is almost never done just to be a PITA. I would keep working with the assumption that there is something really, really hard about that task, you just haven't identified it yet.

Although you describe a range of issues that may be having impact, has he been explicitly assessed for dysgraphia? The writing-specific behaviours you describe sound awfully familiar...

It's so hard to figure out our kids sometimes, isn't it. After all the testing we've done and DS's diagnoses, his behaviour is still sometimes a mystery to me!! Especially at age 6 - it's so hard to tell what is just normal developmentally and what is a real issue...

My DS can write neatly if he really focuses on the task - but it is quite effortful and slow. During the WIAT he had to do a writing test - took him 10 minutes to write one sentence.

Last year DS has some 'behaviour' issues in class - some things that seemed to help him:
* noise-cancelling headphones (sometimes allowed him to concentrate on the task and remind him not to talk to friends while working)
* being allowed to take breaks from the class to get a drink or walk in the halls a bit
* reduced writing/drawing demands for schoolwork/homework
* use of a computer for some of his schoolwork where more writing is involved

First, I would try to tease out whether this is a medication related issue. Can you try writing at home with similar assignments during a more optimal time of day for him and see how it goes? If it's better, can you visit his doctor to try a dose adjustment or a longer acting medication? If it's not better, I'd recommend an OT eval to try to help figure out what's going on.

I seem to remember that slow neat writing can mean the child is individually "drawing" each number rather than having automaticity and can be a sign of something - dysgraphia?

Yes.

Just check that letting him do is writing earlier doesn't result in him missing his favourite class or some fun activity. It is a big ask but could the whole class do writing earlier? (Here until year 8 all core subjects are taught by one teacher so order is more preference but that might not be the case where you are).

Lots of helpful ideas and suggestions here, thanks.

The school has Chromebooks for each student, so if we find that typing is the answer it should be easy to get that in place for him... if only he could type. But I guess I could work on that with him on the weekends. It took me over 10 years to learn how to type well and I didn't get good at it until after college. Hopefully he picks it up faster than I did!

Regarding medication, we recently moved (just to be able to go to current school) and we have had to transfer medication management to the pediatrician temporarily. We are waiting on getting in with the local mental health service provider, but it's a 6 month wait and we have 3 months to go. Even if we wanted to drive all the way back to our old region for the script, the pharmacy won't fill it from an out of area doc on account of it being a controlled substance He had been on 10mg twice a day, but recently he had a growth spurt and I don't know if that was the cause or not, but the 10mg dose was not working enough. I used our weekend supply to give him 15mg in the am (by breaking up 10's) and he continued with the 10mg in the pm (because school has to follow the script). The school reported good mornings, very difficult gap period, and poor afternoons. Even so the pedi would not prescribe the two 15s. She wouldn't even give us the the two 10's. She claimed potential for abuse is higher for short acting med and she doesn't like to prescribe it. She gave us extended release equivalent of 10 mg. I only agreed to a trial of it, so we tried a week. Needless to say it was a terrible week. I collected data from the school and went in fighting and got us 15mg twice a day starting this week. So much better. She still will not give the extended release equivalent of the 15's because she says it's the maximum dose for his age and she doesn't like to give the maximum dose. There's a good reason to let a kid fail at life. So, long answer that basically says, we are trying our best on the meds and being met with resistance. DS has severe ADHD. He cannot regulate himself at all without meds, in any sense. With medication he is like a completely different kid. In a good way! He is the kid he is meant to be but can't be because of his neurology. Sorry, it's very upsetting to me that I have to fight so hard for my 6 year old to get the (IMO life saving) medication that he needs because some 16 year old somewhere is abusing the same medication.

Back to the issues at hand. In the morning the kids have morning meeting and then they do morning work, which is a double sided worksheet with a maze or word search or other fun activity on one side and some questions to answer on the other. DS does the fun side and then never does the other side. The whole thing is optional. This is the time we discussed giving him his required writing work. If it is a medication issue we expect he will be able to do the work just fine at this point in the day. The daily schedule is pretty set at the school, they have a lot of specials and different teachers throughout the day. DS gets a math pull out each day as well to do pre-calculus with a special math teacher.

So, based on the responses here I'm thinking we should look for a good OT and get an evaluation there. We should look into dysgraphia and DCD. We don't really have any money right now and the more qualified people never take the insurance we have, so it's either bug the district for testing (might be tricky with us using private school), use whoever insurance covers (not likely to be a quality evaluation), or save up to pay out of pocket. We are currently looking at paying out of pocket for a 1:1 for a portion of each day, so I don't know when we will be able to afford any of this. We can barely afford the school as it is.

I should add that we love the school. It is well worth impoverishing ourselves for! He is in a class of 5 at an all gifted school that exists just to serve the most gifted students and especially those who have been unsuccessful in prior educational settings. Another boy in the class of 5 has a 1:1 as well. They teach social skills to all of the kids at the school. My son is learning calculus, coding, robotics, and mandarin. He is so happy to go each day. There are 25 kids at the whole school. From what I have seen many are 2E and by far most are difficult and sensitive kids who have a hard time fitting in. They made this school for the kids the school districts could not serve and they are serving them well. I know this school is my son's best chance in life. At public school they wouldn't even consider allowing DS in the gifted program due to behaviors. Now he's getting an all day gifted education and enjoying school for the first time ever. Looks like it's time to sell some stuff off, I think this is the end of the second car

Wow 5 kids a class. Probably makes problems stick out though.