Does anyone know if consistently superior test taking skills would be contrary to a diagnosis of ADHD?

I am still awaiting my final sit down and discussion of my DDs psycho-educational testing results, but when we met with the psych last week, he just looked at whatever the diagnostician gave him and said "well, she definitely qualifies for medication".

After reading some of the ADHD threads here, I am wondering if the fact that my DD has always had superior test-taking skills (other than timed writing) might be in conflict with a diagnosis of ADHD.

Any insight would be appreciated!

There is not a psycho educational test that can definitively rule in or out ADHD, but there are often certain red flags and patterns that diagnosticians look for that may lead to an ADHD diagnosis.

One red flag is a trend of higher scores on un-timed tests relative to timed tests. On the WISC, folks with ADHD often have lower PSI, or WMI or both relative to VCI and PRI. Evaluators often administer tests in the area of executive functioning, and often people with ADHD score lower relative to their thinking skills or academic skills in one or more areas of EF.

But, just because one scores very well on standardized testing, one could not rule in or out ADHD. ADHD is a clinical diagnosis, and the doctor would most likely consider data beyond testing. In fact, if someone does very well on academic standardized testing, but bombs in the classroom - I would want to understand the barrier to classroom performance. Things like organization, ability to stay on task, planning, sustained attention, ability to switch tasks, ability to deal with the big picture and details in a balanced way etc are needed for good grades and classroom performance. Often times ADHD presents challenges in this area. Thus you have what looks like an under-performer. But really, something else could be going on such as ADHD.

I am 99% convinced that I have ADHD, (complicated by perfectionism and some other stuff) and I have (or had!) superior test taking skills. (I also never bombed in the classroom, but certainly underperformed in college.) For me the challenges were (and ocntinue to be) in the areas Mich described above.

My ds10 has adhd and is on medication. His PRI score is 43 points higher than his PSI on the wisc-iv. He has never been behind in school but has never really gotten ahead either. His main issues seem to be with organization and staying on task. He is perpetually messy and without medication he basically requires me to hold his hand and direct him to whatever needs to be done.

I've asked him to clean up a spot of jelly on the carpet 10 times this morning and each time he gets to the kitchen to get the towel and cleaner, he gets sidetracked by the cup of snow he's had in the freezer for 3 days. The first night he tried to melt it with a laser pointer. Then with a laser pointer and magnifying glass. Then he resorted to the microwave. Then he refroze it in the freezer. Then he melted it again. Then he drank it. Who says kids with adhd have no attention span?! He's been entertained by a cup of water for 3 days!!!

Thanks Mich, that makes sense.

Yes, the psych alluded to some discrepancy in her testing, stating she was over the 99th percentile in X but then something inconsistent in Y.

Given that ADHD meds are not an option due to medical conditions, I guess I was a bit bummed out at what seemed to be an attitude of "well if we can qualify her for ADHD meds, our job is done and we need look no deeper" but maybe that is just what it is.

The psych stated that the only alternative to meds was homeschooling! What does that mean long term?

She certainly has EF deficiencies across the board but I am hoping that fish oil and time will help with those.

I guess I'll be back posting when I finally get the to see the test results.

My son is PG and the school was pondering ADHD. When we talked to Davidson, we were referred for a neuropsych evaluation.

Based on initial discussions, ADHD was a definite question mark.

After the testing, the neuropsych said absolutely no attention issues at all. She recommended appropriate placement at school - (skipping 2 more grades) - as a way of addressing the behavior issues.

I'd advise you to check out "Misdiagnosis and Dual Diagnosis of Gifted Children". Read the chapter on ADHD and see what your gut says after that.

I read it and concluded that I bought the neuropsych's diagnosis of no ADHD. I recommended it to a friend and she came to peace, for the first time, with the ADHD diagnosis of her son. She had always felt bad about having him on meds, but after reading the book, she felt better about it.

The bottom line is that it can be hard to accurately diagnose it in a gifted kids. Sometimes, their intelligence allows them to appear not ADHD on a test. Sometimes their intelligence allows them appear ADHD in class or any place else where they are bored.

Mary

Just a note - my son's "adhd symptoms" were helped by fish oil. However, it was also helped with a regular old multi-vitamin.

Are you using a fish oil with omega 3 and 6? We got better results with both than with 3 alone.

Homeschooling has worked well for many people. For us, we did some afterschool math acceleration using ALEKS online math curriculum. The extra intellectual stimulation really helped. One good ALEKS session and he was a different kid for a couple of days. It was freaky.

Mary

Deacongirl, did those skills get better with time? I have read that the EFs keep developing til age 26, and I have been hopeful that means there is a light in the tunnel without meds.

lotsotots, that sound exactly like my DD, lol, yes, major attention span - just not focused when and where you want it to be!!!

Mary, I did read the book and maybe its just me, but I still can't figure it out, my DD is a real "slippery fish". I think she just wants a diagnosis and a magic pill so badly at this point she may not be as helpful in self reporting.

For example, the book says gifted children are more likely to "choose consciously not to complete work as directed or choose not to turn it in - choice is involved" whereas the child with ADHD is unable to complete the work because no immediate consequence is involved or they may not even have brought the assignment or book home. Both scenarios could fit equally well. Then there is situational specificity: she is not consistently distracted and can sit still for hours and hours reading (so focused she forgets to eat or sleep even). The book says:

"Parents of gifted children who do not have ADHD will quickly say for instance, "oh, yes. She's passionate about reading, and when she reads, she's as unmoving as a stone. She would read for hours if we let her, and she is unaware of virtually everything around her" Such a child is very unlikely to have ADHD"

So that leaves me confused, she seems to have the traits of ADHD and the traits of gifted without ADHD.

I bought the Nordic Naturals Omega 3 which has both types, I also bought soy-milk with dha, flax-seed cereal and every form of salmon known to exist. So far my DD hasn't tried the pills but my husband and I are taking them and I feel great!!!!

I gave my DD the pills to try and she came home in a great mood, and was unusually sociable and pleasant and we played with musical instruments together for a couple hours, when I asked her if she thought the pills were making a difference she told me she "palmed them" to see if I would incorrectly attribute them to an imagined change in her. So she is messing with my psyche. Did I mention that we diagnosed her with oppositional defiant disorder after reading that section of the misdiagnosis book? ;-). Maybe if the doctor tells her to take the fish pills she will do it.

"Parents of gifted children who do not have ADHD will quickly say for instance, "oh, yes. She's passionate about reading, and when she reads, she's as unmoving as a stone. She would read for hours if we let her, and she is unaware of virtually everything around her" Such a child is very unlikely to have ADHD"
(Sorry don't know how to do that quote thing)

Hmmm...I just don't think I agree with this. I have been reading/reflecting trying to tease out adhd from giftedness for over a year now and I truly believe that I have exexcutive function deficits that are best explained by adhd (but were exacerbated by a not-challenging enough environment.)

And...sorry to say the skills have not improved with time, because the coping mechanisms I was using are simply inadequate to manage mothering 3 kids and a house with a husband who works 80 hours a week.

"The extra intellectual stimulation really helped. One good ALEKS session and he was a different kid for a couple of days. It was freaky."

This I think is so true. Part of my problem now is being in a geographic location that is just not meeting my needs intellectually. (Not that it wouldn't be possible, but the executive function/planning issues make it extremely difficult for me...if we lived, say in NYC, it wouldn't take as much planning/organization to find something intellectually stimulating to do and like-minded people to do it with.)

What about hyper-focussing? My DS10 can sit and read for hours as above, and is *completely* unaware of everything around him. On the other hand, he has almost all the ADHD traits Mich described so well above (organization, attention shifting, staying on task, completing projects). And his VCI is 42 points higher than his PSI. I'm planning to discuss the possibility of medication with our pediatrican next week.

LotsOTots5: my DS10 has done very similar things with frozen water!!

"And...sorry to say the skills have not improved with time, because the coping mechanisms I was using are simply inadequate to manage mothering 3 kids and a house with a husband who works 80 hours a week."

Gosh, that sounds tough, did you end up taking meds? Have you tried fish oil (Omega 3?)

Verona, does your son put together legos or models for hours too? My DD would make great clay creatures and spend lots of time putting in details, she also would spend a lot of time practicing an instrument, is there a difference between hyper-focusing and just choosing to focus on what you are interested in and choosing not to do stuff that seems pointless?

I guess that is one of the things that throws me, my DD said she saw most schoolwork as pointless since she mastered the material quickly, and being told to do the work just for the sake of the almighty grade just didn't cut it. That made lots of sense to me but when I mentioned this to the psych, he said "well that's just the excuse".

There are many ADHD "look alikes" and it is sometimes difficult to tease out what is causing the symptoms. Your evaluation is a good start - especially if it looks at academic skills, EF skills, language processing skills in addition to IQ.

I disagree that homeschooling is the only choice for a child with ADHD that cannot take medication. As you have noted, there are some supplements that can help, exercise has been shown to be a help, and schools must offer accommodations and supports to help students compensate for the affect (or is that effect) of ADHD. There are schools that specialize in teaching EF skills and they often provide a learning environment that is multi-sensory and structured so that the student can thrive. Some public schools offer explicit instruction in study skills, organization skills etc so that their students with ADHD can be successful. If needed, the law requires diagnosed students be afforded reasonable accommodations such as extra time.

I have one child that is gifted, has profound dyslexia and ADHD. When we first started out trying to understand him, I could not believe that ADHD could be part of the mix. He is calm, extremely well behaved and could sit still for hours when we went out to eat, working on art projects or spend hours playing in the woods. What I didn't realize is that because he became so distracted and entranced by things happening around him (ADHD), it looked like he was on task. Really, his mind drifted around constantly. And, when it comes to school work and chores, it takes him FOREVER to complete things. As it turns out, ADHD was part of the mix, and luckily, medication helps a lot.

For my daughter (not gifted), she has some processing and concentration issues, and we found that she has learned to compensate without medication. She worked with a tutor for a year that taught her how to study, organize, stay on task. We were able to secure a 504 plan at school that allows her extra time on tests. She went from a B/C student in college prep level classes to an A student in honors and AP classes without medication - just by learning the EF skills and by being given the time she needs to complete tasks.

If you are not already working with a medical doctor that specializes in ADHD, I would suggest that you seek one out. It is difficult to determine if a gifted child has ADHD or other challenge. A specialist will be able to analyze all the data and help you "peel back the onion" to help determine if it is more likely that your child has ADHD or another condition.

Good luck!

Mich, how did you teach EF skills?

DeeDee

Yes, he does focus for long periods of time on drawing, legos, and computer stuff as well as reading. Other posters have said that some children with attention problems *can* pay attention but it takes much more effort than a child without an attention issue and might not seem "worth it" for uninteresting tasks. Or they might "use up" their paying attention capacity and become difficult and emotional (I see this in DS).

I should also mention that we don't have a diagnosis of ADHD for DS10 and I am still very much on a learning curve! From what I have been reading here, our psy. maybe didn't do all the testing needed to figure out what's wrong. He said NVLD (based on WISC scatter and a reading and writing evaluation), but there seems to be such overlap between NVLD, ADHD, EF dysfunction, and some aspects of Aspergers that I'm not totally convinced.

"but there seems to be such overlap between NVLD, ADHD, EF dysfunction, and some aspects of Aspergers that I'm not totally convinced"

I know what you mean, I feel like my DD has a little of all of the above with a touch of ODD and existential depression. I think puberty really put the final straw on top of the pile.

I'm not Mich, but there is a lot of literature out there on this subject-- a lot of it is geared toward pre-adolescent kids, since that is where the executive skill set first becomes 'out of sync' for kids that are at all asynchronous.

One of the things that I read recently was
Smart But Scattered by Dawson and Guare

The two of them have an older book in this area, too:

Executive Skills in Children and Ad...cal guide to assessment and intervention

I've not read the latter, but the former is extremely accessible and thought-provoking.

I keep wondering if you can have just have stand alone low EF. That is what I see at our house...

Apparently yes. Mich wrote a really helpful post on this a while back (see "feeling stuck" thread from a few months ago).

I've recently read this book. It contains a lot of common sense recommendations (lists, rewards, consistency), and we were able to figure out why what we'd been doing in the past hadn't worked (mostly in that we'd stop the process too soon).

The book recommends working on no more than two things at a time. Taking that recommendation, we're continuing the system we started before I got the book (homework neatness & completeness) and one more task (emotional control in playing games). We have a list of about 10000 other skills and tasks that drive us nuts and hamper our daily lives or DD's education. Those are in line according to urgency.

It seemed to have much lower expectations for EF for an age group than we have in this house, and significantly lower expectations than schools seem to have for children. I was left with the sense that I shouldn't even be reading the book based on the expectations of kids in grades 1-3. Even if I were to look at expectations for older kids, DD (age 8) would generally be marked as fine. And yet, she cannot be relied upon to finish getting herself dressed once she starts. This left me with the sense that they underestimate how much you can teach a kid with respect to EF, and wondering if maybe we could tackle an additional task or two right now.

I'm mich - but I wasn't the one that did most of the teaching! My son's LD school integrates EF skills in everything they do and my dd's tutor helped her with study skills and organization. That said, two books I found useful are:

Late Lost and Unprepared
No Mind Left Behind

Late Lost gives strategies that can be used in family and school life. No Mind also suggests strategies, but also breaks down EF into subskills (called the 8 pillars), which makes it easier to pin point your child's strengths and problem areas.

My dd's issues center primarily around her working memory and being able to sustain attention. Her tutor taught her study strategies to help her better comprehend her assignments, test/homework questions, and academic content. She now does a lot of pre-reading such as reading chapter questions before she gets started, reading the titles, subtitles, picture and data boxes etc, Then, when she goes back and reads the chapter, she is better able to tie it all together without her mind wandering. She also takes two column notes and uses various study strategies such as making study guides and flash cards.

Both my kids have always been pretty organized about plotting out their work, setting and meeting milestones. They run into trouble in that it can take them an inordinate amount of time to complete tasks - especially when they get side tracked. So, they've learned to manage their environment to minimize distractions. DD uses a timer in the morning to keep her moving from her room, bathroom and breakfast. (doesn't always work, since she can override it when she wants to make one of her multiple outfit changes). DS finds it important to break down tasks and allow time to stretch, exercise and refresh every so often to get his brain going. He benefits from "systems" and "routines" to stay on track and self monitor.

geofizz - I do think that the expectations in school are too high - especially in middle school. Students are expected to juggle increasingly large amounts of work, at the same time teachers are removing much of the structure, guidance and feedback. I think that many times kids become overwhelmed - not so much with the content of academics, but how to their work in a quality way.

Well, here is an update: the official diagnosis was....(drumroll)...

"significant cognitive processing deficits in the areas of executive functions" (no surprise there), and despite "average to above average academic achievement in all academic areas", "ADHD, primarily inattentive type", "pervasive developmental disorder not otherwise specified" and "situational depression" typical of students attempting to cope with learning or attention control differences. And although criteria was met for borderline Aspergers, it was determined that the overlaps most likely were actually due to ADHD.

So, after much angst and many discussions with family and our physician and against all my previous beliefs, we are...GASP, GOING TO TRY MEDS. (turns out I was a bit wrong about the family medical history).

I am scared to death, and at the same time so hopeful...please wish us luck (I'd appreciate prayers of any kind too!) - we start tomorrow.

Nik, I'm glad you're starting to find answers, even though they are not neat and tidy answers.

It's curious that they said borderline Aspergers-- if they already diagnosed PDD-NOS, the Asperger's diagnosis would be superfluous, as both PDD-NOS and Asperger's are on the autism spectrum. They'll be folded into one "autism spectrum" diagnosis in the next DSM anyway.

Meds were one of the best things we ever did for our child on the spectrum. Nobody really wants to put their kid on meds. But taking away his anxiety allowed him some relief from suffering and also allowed him to access the therapies he was getting. He was more able to control himself, and therefore felt better about himself-- the meds helped us achieve an upward instead of downward spiral.

I hope you can come to feel at ease with this choice. It won't be "magic," for sure, but I do hope it will help your DD. You can PM me if you want to talk about details.

DeeDee

Thanks DeeDee,
Beyond fears of an adverse reaction, I am worried that it wont be the "magic" that my DD seems to be hoping for.

For every time I tried to warn her not too expect too much, someone else (diagnostician/doctor etc) would tell her it will make an amazing difference almost immediately! Of course then they tell me that the medicine is just part of the solution and that she will need to work hard on her skills blah blah blah - but I think all my DD is hearing is the first part. The diagnostician did tell me that once on the meds, she would be more likely to recognize the need to work on the skills and would probably be more willing to do it.

Fingers crossed, "upward spiral", I like it!!!

As for the Aspergers, the commentary was not in the diagnosis, just in the report since they had rated the GADS. The diagnostician really didn't want to go with that since she said she can usually tell within minutes if someone has AS and she just didn't see it in my DD.

Best wishes Nik, I'm sending positive thoughts to you and DD.

Let us know how it goes.

Good luck, Nik. I hope the medication goes smoothly and you are able to find the correct dosage without much trouble. Remember, sometimes finding the right medication and dosage can take a bit of trial. But, from my son's experience, medication has made the single biggest difference (positive). It doesn't teach him the skills, but it makes him more available to learn and implement them,

Thanks for the well wishes, so far so good!

She reported on day one with the meds that she could quickly access info that she usually had to struggle to bring to the forefront and once she had found the right word etc, she still remembered why she was looking for it.

She also has actually slept through the night two nights in a row (1am to 7am) and has been able to get up without a struggle. And...she sat down and wrote a short essay that was due for school without having to be nagged!

She also proudly reports that she is now successfully keeping 7 sims going at once whereas before she could only manage one(!?), Well, it's all worth it right there, now she can be an even better gamer hmmmm... (actually, Sims was a recommended game for teaching EF skills so maybe that is a significant improvement)

Is it too early to declare a success and celebrate???? Would we know by now if there were going to be adverse side effects?

Nik, that sounds good so far!

With side effects, every drug and every person is different. SSRI antidepressants take a while to build up in a person's system-- typically we've been told 6 weeks to full effect (and full side effect if there will be any). Stimulant ADHD meds gave our DS side effects immediately; they're short acting. So it depends on what you're giving, and how her system responds...

Wishing you well--
DeeDee

Thanks DeeDee, we have the stimulants - 10mg twice a day.
She had a headache yesterday, but it wasn't any more severe than the ones she gets periodically anyway, so I don't know if it was related.

I am wondering how closely I need to watch her and for how long. I couldn't believe how dismissive and unconcerned the doc and the pharmacist were, basically saying there are no side effects when the sheet that comes with the meds has a long list of them!

Keep an eye on the headaches - sometimes stimulants can affect blood pressure and a head ache can be a symptom. For my son, lack of appetite and difficulty falling asleep are the two main side effects. Sleep tends to resolve itself in a week or two after he gets accustomed to the medication after being off of it for awhile (summer and vacations).

Based on what you report - it seems like the trial is successful. As DeeDee says, you can tell immediately (well, within 30 minutes) if the stimulants are working. Sometimes there is a let down when they wear off (sadness, mood swings), but again, you would see that the first day.

Sounds great Nik!

Once you had the ADHD-inattentive dx, did your family doctor decide which medication and dose to use? Did the neuropsych. or psych. who did the assessment have any input? Asking just out of curiosity, as we may be going down this road after my DS's neuropsych. assessment (unfortunately not until May).

Anyway, congratulations on a good start!

Thanks for the heads up about headaches Mich, so far it was just the one, but I'll be monitoring that.

She is actually sleeping more consistently than I can ever remember, albeit only 6 hours a night (1am til 7am) but she falls asleep and stays asleep on a schedule that is functional, so - added benefit! We are going to try melatonin to help her get to sleep a little bit earlier.

Verona, the diagnostician raved about adderal xr that her DD22 was taking, so I assumed we would get that but they aren't the ones to write the prescription. My DD had an annual check up scheduled with her Dr. the day after we got the report, so I brought it just to discuss, and before I knew what was happening, I had a prescription in hand. We got a generic for Ritalin, probably because our Dr knows I have a terribly high deductible insurance plan that wont pay for meds. Apparently, the generic has less side effects too so - bonus! So if we stick with these, it's only $20.00/month, much less than I had feared.

Honestly though, I really wish I could go back in time (to when my DD was younger and had more faith in my judgment) and really give the fish oil a chance. I would do an experiment: test DD with the number recall exercises and record her responses, then give her 2 Nordic Naturals Omega-3 fish oil gels daily for a week and then re-test and see if there was a significant improvement.

I have been taking the fish oil pills for a couple weeks and I feel great, happy and energetic, could be placebo effect, but I have the pills and they are good for the heart so I figured why waste them.

Thanks Nik for the information.

DS11 and I both started melatonin about 4 days ago (I also have insomnia -- the apple doesn't fall far from the tree) after discussing it with the pediatrician. I'm a convert! We both fall asleep within 15 minutes. Waking up during the night is still an issue though. DS has been waking up around 4-5 am (and standing spectre-like at the side of my bed until I wake up too) but is able to get back to sleep for while before the alarm goes off.

My DS does seem happier and more together lately with the new regime (500mg DHA supplements, tea in the morning, melatonin at night, nutured heart approach all the time), but not enough to make me cancel the neuropsych. evaluation or stop looking for a different school placement for next year.

Hi Nik

I am 31 years old and was just diagnosed with ADD myself...I have always been a top student even if I was a huge procrastinator and was consistently disorganized. I found ways to compensate. If your child is gifted she can too.

You can be both ADD and gifted. I highly recommend reading Different Minds by Deidre Lovecky.

I love that book 'Different Minds' - but I hate to admit how many times I had to try reading it before I could even get 3/4 through it. ((red face))
Love and More Love,
Grinity

LOL! I have a whole shelf full of books that I recently purchased on ADD/ADHD, AS, EFs and parenting...so far the only one I have been able to get through in one sitting was Aspergirls. You would think someone would realize that most parents of ADD kids probably have some attention issues themselves and make the books more "short attention span friendly"

Exhausted, I know it can be done but I think there are varying levels of impairment and related difficulties, if you were always a top student then I don't think you were dealing with the same level of challenge as my DD, either that or your educational fit was much better than what she has been dealing with.

I feel fairly certain that my DD would be successful at her dream college even without the meds due to the excellent educational fit, but I guess I am too chicken to gamble with that kind of money and I think it comes down to a quality of life thing, why suffer/struggle so much more than you have to. With the meds, she can focus more on building the skills and habits that will hopefully eventually make the meds unnecessary. At least that's my hope.

Verona, I am so glad to hear your DS is happier and I definitely wouldn't give up looking for a better school situation. The neurospych eval will be helpful for understanding what is going on and how to help him use his strengths to bolster the weak areas etc, regardless of whether or not you end up trying the meds. We are going to try the melatonin over spring break (in case it works too well :-)).

Ha! Yes, I did have trouble getting DS out of bed for school this morning. But he's probably getting 1-2 more hours of sleep per night than before the melatonin, and he looks so much better too -- no dark circles under his eyes.

The fact that he responded so well to the the melatonin makes me think even more that maybe a neurological issue like ADHD is at play, since I read that kids with ADHD or ASD often have low or no melatonin production. Does anyone have an opinion about this? The melatonin is helping me sleep too (and I don't have ADHD, just insomnia!) but not so dramatically as DS.

Here's a link regarding Melatonin and ADHD.
http://www.childdevelopmentinfo.com...lp-adhd-sleep-problems-in-children.shtml

I know plenty of kids with sleep problems that Melatonin didn't help, but it was wonderful for my son, who is 2E: PG and ADD. We started when he was 8 years old, and it was remarkable, the first time I had ever seen him in a drowsy state in his entire 8 years. Even as a toddler, he would get 'wound up' instead of sleepy. He loved not laying in bed waiting hours for sleep to arrive. He is also a very light sleeper, woken up by the slightest noise, and able to be instantly alert even when breathing deeply and regularly for 30 minutes.

I've also heard that kids who get even an hour less sleep than average per night tend to act like children a grade or two younger in terms of ADHD-like behaviors. So there must be a few kids who have ADHD behavior merely from lack of sleep. Once my son started taking stimulants for his ADD, he didn't seem to need the Melatonin anymore. Of course that was around the time that he started being allowed to stay up later than us, so it's hard to tell.

Verona, I'm glad to hear that your son has no more dark circles! Try making the bedtime, and the administration of melatonin time even earlier - see what happens!

Love and More love,
Grinity

This is my DS too. Never got "sleepy", just more and more wound up even as a newborn. I think I committed the book "Healthy Sleep Habits, Happy Child" to memory by the time he was a year old. He has a white noise machine that seemed to help a bit, but the melatonin is a real miracle so far! I've been trying to push the bedtime a bit earlier, but he is pretty rigid about 9 pm being the moment to turn out the light (not, say, 8:58 pm).

I wouldn't say that the extra sleep makes his attention and organization issues disappear, but he is certainly more compliant (that's a relative term mind you) when he's not over-tired.

So the stimulants didn't cause sleep problems for your DS?

one test that my son was given, among many, was a computer based test of concentration, where the child is required to concentrate on something pretty boring. He is very VERY active. He has trouble listening, but can focus when things are of interest (his interest, not mine, of course). He did 'average' on this test, and this helped confirm, along with other information, that he does not have adhd (although many strangers have kindly suggested it!
Just mention it in case your testing did, or did not, include this test...I can did up the name if you like.

I also don't get 'medicine or homeschool' as the only options; doesn't adhd usually mean a child can't function well anywhere? if they are only having issues at school, isn't that a red flag that something at school is an issue?

(The phrase 'well they definitely qualify for medicine' is a very odd way to put that too, imo)

Hang in there! It does take time to process all of the info from one of these assessments, so give yourself time to do so.

I think the point here is that a child who isn't functioning 'well' at home might still be able to learn more at home where his behavior can be more comfortably accomidated. And while most teachers wouldn't blame or shame a kid with ADHD behaviors for what the child can't control, there are always those that do. At home, also, the parent or tutor can design a day that makes the most of a child's interests and readiness level.
Does this make sense, chris1234?
Grinity

�one test that my son was given, among many, was a computer based test of concentration, where the child is required to concentrate on something pretty boring. He is very VERY active. He has trouble listening, but can focus when things are of interest (his interest, not mine, of course). He did 'average' on this test, and this helped confirm, along with other information, that he does not have adhd (although many strangers have kindly suggested it! �

We did not get such a test, but I am kind of curious how they determined that the thing in that test was in fact �pretty boring� across the board? I can just imagine the scientific study, lol.

I have seen my DD concentrate for long periods on plenty of things I would have thought most people would find quite boring.

Thanks for the encouragement Chris, I am still digesting the dx but at least it gives me a place to start. Just for background: my DD17 never got in trouble at school for anything that would have made me wonder if she had ADHD, she simply never turned in any homework but her grades were okay and her test scores were excellent so I wrote it off as her being bored and unwilling to do what she considered pointless work. I knew she wasn�t being challenged by the school, but there were no other options available for her at the time so I sympathized and let it go as long as she was passing all the advanced classes. She has always been a bit of a handful at home, but I didn�t realize that the constant questioning of rules was just a gifted issue and the lack of organizational/planning/time management skills was something more than laziness. I only started to think there was a real problem when she couldn�t pull it together to write her college application essays in a timely manner for the school she desperately wanted to go to. Then I realized she really never did produce high quality written work on demand so I wanted to find out if she had some kind of LD that was making writing especially difficult for her. That�s how we got started down this road to discovery!

"I think the point here is that a child who isn't functioning 'well' at home might still be able to learn more at home where his behavior can be more comfortably accomidated. And while most teachers wouldn't blame or shame a kid with ADHD behaviors for what the child can't control, there are always those that do. At home, also, the parent or tutor can design a day that makes the most of a child's interests and readiness level."

I think that's probably true Grinity, but I don't think that was what this Psych was saying, I really got the uncomfortable impression that he saw the purpose of medication as being to make the student more compliant/acceptable to the school. Hopefully I was wrong there, but I got the feeling he really didn�t even read my DD�s case file beyond IQ scores.

I'm still on the fence about the decision to try the medication but my DD said it really does help her get her thoughts in order (i.e. find the right word right away and still remember why she was searching for that word in the first place).

So far, so good but after one week of sleeping solidly from 1am to 7am while on the meds, her sleeping is back to being erratic. She took a 3 mg melatonin Friday night and slept all day Saturday(!) The Dr said we could adjust the ADD med schedule and take the 2nd dose earlier so she could fall asleep earlier than 1am...she tried that yesterday and couldn't sleep at all last night. She doesn't want to take the Melatonin regularly because she is afraid of getting addicted to sleeping pills...if anyone has links to studies that show otherwise, that would be helpful.

After watching the "wayseer manifesto" video on you-tube with my DD, I got all teary eyed and asked my DD if she thought maybe the meds would stunt her amazing "outside the boxiness" and she assured me the meds do not affect her thinking, only the efficiency of it and they greatly reduce the frustration of not being able to think efficiently.

So, I am feeling pretty good about trying the meds (for today anyway!)

I totally get the fears around medications and their effects. On top of that I hate the 'medication merry-go-round'
Try this version of a stimulant -
Try adjusting the dose -
Try that version -
Try an non-stim
Try a combination -

It can go on and on - and did for us. But when it finally clicked, my son felt so 'right.' Golly that made it all worth it.
All I can say is: Trust your mom-gut.

l&ML,
grinity

I just don't buy that. Is this the same person who diagnosed situational depression?

ADD inattentive kids are usually not poorly behaved, or defiant at school - although they may have EF troubles that keep them from turning the homework in.

Your report of the exchange reads to me that the Doc wasn't able to establish repore with you, and was a sort of 'shoot from the lip' kind of person. I know how hard it is to put comments from authority figures out of one's mind, but honestly I would try to smoosh the memory with a 'even if he and I don't agree, he probably believes he has my child's best interest at heart.' and then turn it into an interesting footnote.

Love and more love
grinity

Thanks for the link Nik, I had no idea.
At First I thought it was an iphone advertisement - but no.

I have to say that personally I appreciated the slick effectiveness, but the politics are totally bogus in my opinion. "The Frontal Lobes are the Gestapo of the Mind" is untrue, and offends me deeply. The frontal lobes are a part of the brain that helps folk achieve their goals. MLK and Mother Theresa must have had very strong frontal lobes to accomplish what they were able to accomplish. And the Matrix is my favorite movie! Heartbreaking to see it chopped up and used that way. I hated that 'us' vs. 'them' mentality - 90% blabla. And I find it to be false and dangerous.

To be honest, I'm about as 'out there' and 'unbrainwashed' a person as one could want - and I find the 'wayseeker' stuff superficial and manipulative and 'off base.'

I'm not renouncing any part of my brain nor any tie with all of humanity.
Love and more love,
Grinity

Hi Nik,
Melatonin is a hormone that your brain produces when it gets dark out and it makes you sleepy. It is not addictive and is not a "sleeping pill". There haven't been too many long term studies of its use, but the ones that I've seen don't show any problems with taking it regularly. Some studies have also shown that kids with ADHD and ASD make less Melatonin than others. Melatonin is also used with visually impaired people, since they don't produce the hormone in response to changes in light. My pediatrican had no problem with my son taking it regularly. It is not a prescription medication (at least in Canada).

Also, if the 3 mg Melatonin is too much, try cutting the dose in half. 3 mg is a lot more that the average person produces naturally (about 0.3 mg I think).

You can check out Grinity's link to the article on melatonin and ADHD on this thread.

Grinity, thanks for your insight on that video, I felt so conflicted after watching it, it was a HUGE relief when my DD said that the meds really did not inhibit or alter her thinking at all but rather made it less frustrating and more efficient. I do see though, how the "us against them" mentality could arise when so many are so often mistreated/misunderstood because of their uniqueness. I can see the desire to turn it around and celebrate the positive aspects of it, but perhaps this took that just a little too far. Honestly, until a couple of months ago, I truly believed that ADHD was fictional affliction and that the meds were the "powers that be"'s way of handling the "difficult kids" by drugging them.

As for the Psych, I don't know how much of the report he had anything to do with, the diagnostician spent the most time with my DD and built a rapport with both of us, she mentioned suspicions of ADD inattentive and depression on day 1. The Psych met with us for 30 minutes 3 weeks later and did not really say much that indicated to me that he had looked past the summary provided by the diagnostician. He kept looking at his watch and yes, the few things he did say rubbed me the wrong way but I think we got closer to where we needed to be whether it was because of him or in spite of him so I am not going to sweat it. It just added to my uneasiness over the whole meds thing in the first place when I was hoping the Psych would be able to reassure me in some way.

Verona, thanks for the info, I will share that with my DD although the article states something to the effect that the methodology in the current research needed some work. My DD is very much of the "show me the valid research or I wont believe it" mentality.
Wow, I wonder why the Dr suggested 3mg to start with, my DD isn't all that big either!

Thanks, as always for the insights and responses.
Nik

I didn't read the whole thread, my apologies. But visual spatial thinking kids are totally characteristic of ADHD. Just the nature of their thinking. And the mess that goes with it.

I would do a project and a tornado around me. When the project was done, then I could cope with clean up and organization. I could not cope with the mess in mid project. No way, no how -- as an adult, being paid for what I did. A child is just starting to deal with those issues.

Ren

Over the years my son has used 3mg, 2mg and 1mg dose...sometimes it just seems like we had to move up or down. He doesn't use it all all now, with a roomate and a later bedtime, and working out regularly he doesn't seem to need it.
((shrugs))
I wonder if your DD will buy the 'it's a hormone, not a drug' argument. I certainly did. I love research and all, but sometimes one has to go with what works. I don't think it's risk free 'because it's natural.' These are hard decisions.

I'd love to see your DD doing some meditation if she doesn't want to continue with the Melatonin.
Here are some resources to get started:
https://sites.google.com/site/giftedmeditation/
And meditation has research behind it, too.

Shrugs and More Shrugs,
Grinity

3 mg is the standard adult dose for melatonin (that is what my pediatrician suggested for my son as well, even though he only weighs 85 pounds), but I've been giving him less so far.

There is also lots of research behind "good sleep hygiene" to help insomnia -- she could have a look at this too. Regular wake up time is really important, and doing something relaxing (not looking at a screen) in the evening also helps.

Don't teenagers generally have a shifted sleep schedule where they aren't sleepy until really late, and want to sleep in most of the morning? Too bad about having to get up for school!

Well, in both the long-term and short-term I'd say it means you need a new psych.

In absence of meds-- or even with them-- what needs to happen is an emphasis on teaching coping skills and adaptations while the school offers accommodations like perimeter seating, homework changes (all homework assigned Monday and due Friday, Mom can decide when there's been enough work done for the day, only requiring enough work be done to show mastery rather than the 40 problems assigned the class, etc), untimed or small group testing, etc. The school counsellor can meet with the child to work on executive functioning skills if she's able; theoretically that's the job of an OT but as long as it gets done I don't quibble. (You can google accommodations to find common ones.)

Refusal to comply or questioning rules is not only a gifted issue, it's also an AS issue. They have trouble recognizing the social hierarchy and that other people, by virtue of their roles, are allowed to give them instructions.

Worst case scenario: There are a few news stories every year about people on the autism spectrum who don't recognize that the police have authority over them and can't comply, and get into serious trouble. Rare because of watchful parents, but it happens.


You DO want someone to actually pay attention to the details of her behavior. At least, that's what we have come to expect from our developmental pediatrician who prescribes meds. If it takes an hour for me to weigh pros and cons with her and feel confident in her decision, she takes an hour.

And yet-- the way you frame this here concerns me. I don't think it's helpful to see your DD as though her raw giftedness will be altered/muted/taken away by meds. It's likely the opposite is true; by helping her manage her neurological quirks, meds could help her be the person she wants to be.

Compliance is NECESSARY for social functioning. Just try to hold almost any job without being able to comply with safety rules or the rules of the job. Understanding whose rules to follow is something most people have mastered. by your DD's age. I know the doc's phrasing was a turnoff-- and I wouldn't blame you for seeking another doc-- but raw giftedness alone without the social skills to manage it is not such a gift, as you've seen.

If meds can ease her stress and help her manage, I'd encourage you to stick with it.

DeeDee

Thanks Verona, I have downloaded some sheets on good sleep hygiene. It seems now that the weekends are the biggest problem since she has no legit reason to get up early. (Hopefully, soon a job will cure that :-)). The Melatonin seems to help her get to sleep earlier but not sleep longer, so instead of sleeping 1am-7am, she sleeps from 10:30pm - 4:30am(!) I am thinking we will try the melatonin just on weekends/holidays to help keep some sort of schedule when off the meds.


I realize now that I should have started this long ago, these things surely would have made my DDs public school experience much more tolerable/enjoyable. She is 17 now, and finishing up with homeschooling and her last 2 courses in college. She will be going to an amazing college in August that does not believe in busywork assignments or timed tests and only has small group classes where the teachers are called "tutors" and they facilitate the discussions among the students rather than perform an authoritarian/dictatorial role in class. I think this environment will fit my DD very well without extra accommodations. If the meds make it possible for her to harness her thoughts efficiently enough to write her papers, then I have high hopes for her success in college.

I do think I need to find a way to help her with coping skills and EF skills. I am having a really hard time coming up with a reasonable plan for that because:
a) the shaky parent/teen relationship at this point (although that has been improving exponentially lately)and mostly,
B) because these are areas that I struggle with too and my DD is very different from me, so she balks at the strategies that work for me.

I would love to find a coach to work with her but money is very tight right now and I don't even know where to find the type of person that I need.

"Refusal to comply or questioning rules is not only a gifted issue, it's also an AS issue. They have trouble recognizing the social hierarchy and that other people, by virtue of their roles, are allowed to give them instructions."

(sorry, I don't know how to quote twice in the same response!)

I am still trying to determine how much of this is Aspie and how much is Gifted and/or ODD. I don't remember my DD having problems with authority/rules when she was a lot younger, in fact people used to comment on how well she minded me. I think it was at about age 11 that she declared herself to be equal to adults. She has told me recently that if I would have just explained valid reasons for the rules/expectations, she would have followed them.

"And yet-- the way you frame this here concerns me. I don't think it's helpful to see your DD as though her raw giftedness will be altered/muted/taken away by meds. It's likely the opposite is true; by helping her manage her neurological quirks, meds could help her be the person she wants to be."

You are absolutely right Dee Dee, I am no longer concerned about the meds changing her personality, I realize this fear was misplaced. My DD has reassured me they do not affect her in that way and she has convinced me that they are helpful, so I do plan to stick with them.

I do have some questions about the meds:
The first trial of meds has shown to be helpful with no adverse side effects...I guess I should count our lucky stars...but how do we know that a higher dose wouldn't be even better? My DD mentioned that they do seem to help but not like the first day, am I looking for trouble in thinking a higher dose might be even better?

Do the ADD meds also help with anxiety? I can't tell if my DD suffers from anxiety or if what I suspect is anxiety is really just a combination of other issues. The diagnostician told me I would probably need to help my DD with "starting" things. That she has issues with the act of getting started. Is that an anxiety issue or an EF?

Thanks so much for everyone's continued help and support help as I muddle through all of this!

"...by helping her manage her neurological quirks, meds could help her be the person she wants to be."

As someone diagnosed with ADD as an adult, this has been my experience. I feel *more* myself when on meds.

Also--"I only started to think there was a real problem when she couldn�t pull it together to write her college application essays in a timely manner for the school she desperately wanted to go to."

College applications seemed like an insurmountable task to me--so I chose to apply to a school with rolling binding early admission, because completing only 1 application and being done was the most attractive choice. In retrospect I know a big part of that decision was because I was overwhelmed with all of the applications. It was a great a school, and if I knew then what I know now, it could have been an even better experience and education. But it was not the best fit, and knowing what I know now, I would have chosen differently.

Sounds like 10:30 pm was too early for her to go to sleep and that's why she woke up at 4:30 am (same thing happens to me if I go to sleep too early). I was told to start by deciding when I needed to wake up (say 7 am), then decide how many hours of sleep I needed (say 7.5) and calculate the appropriate time to go to sleep from there (11:30 pm) and not to go to bed earlier, even if I wanted to!