Ok, I�ve been a lurker for quite a while here and am so incredibly thankful for everyone sharing their stories/struggles and opinions. So here�s my turn.

DS6 is in a HG program (supposedly have to be 99.5 IQ and achievement to qualify) with our school district, yet even in this group he is an outlier. We had him tested at 4 by a local psychologist because of my concerns for Aspergers (spaciness, social immaturity, incredible focus on certain things but oblivious to others, getting very upset and difficult to calm in certain circumstances, large motor issues, sensory processing issues etc). At that time the psychologist did an eval and gave a dx of Anxiety NOS. The psychologist did an IQ test at that time which put him in the gifted range (high 130�s to low 140�s)

So fast forward to now. 1st grade in a HG program which is an �enrichment type program�. He�s reading at 6-7th grade level, Math at about 4th (had to strongly encourage the school to test him for placement in the 3rd grade math class). The majority of his �HG� 1st grade classmates are working on about 2nd to 3rd grade reading, 1st grade math (single digit addition/subtraction), simple spelling (of, that, send, etc.) (he adds his own words for spelling practice � last week these were Athena, citizen, earthquake, nemesis, cider)

So here�s the problem. He was so excited about going to 1st grade, but now not so much. He has been having a meltdown at least weekly, he is disrespectful to school authorities during these meltdowns, but the rest of the time is very respectful, wants to be a good kid, is what I would describe as a gentle creative, quiet boy. The meltdowns seem to be triggered by relatively minor things that he thinks are unfair, but he is very difficult to calm down and as I said above he becomes very verbally disrespectful to everyone around him. He�s still very spacy during class � playing with his hands � pretending they�re spaceships, staring through the blue color of his clipboard when he�s supposed to be listening to the teacher, fidgeting with and dropping his pencil/ his paper , but has no problems keeping up with the schoolwork.

So meltdowns, spaciness, social immaturity; Is this twice exceptional behavior? Aspergers? ADHD � inattentive type? Bored gifted? Asynchronous development? Dombroski�s overexcitabilites? �..All of the above? His IQ scores put him at the same level as the other kids in his class, so why is he so different?

Just venting and sharing....what would you do? The school officials seem to be at a loss of how to deal with his meltdowns. They want their school psychologist to do an behavioral eval � she�s sweet, but just graduated from college with no special training in gifted behaviors. Part of me wonders if a lack of challenge is part of the problem behind his behaviors, but I don�t think a grade skip or two is good because of his immaturity, and his handwriting (which is about typical 1st grade). Any suggestions to help stop meltdowns or provide more engagement in the classroom so he�s not so spacy?

Thanks for letting me share.

Sounds a lot like my son (ADHD). I think it just exacerbates all the underlying things that go along with being gifted. His sense of fairness is amplified by like a thousand and he'll freak out and have a fit. His perfectionism has gotten so bad he was literally crying last week at school because they were going to have a math test later that morning and he was afraid he was going to FAIL it. This, from a kid that gets 100's on nearly everything.

We've started him on concerta and it's really helped him. He still has his meltdowns (like the math test one) but overall his issues have gone from being multiple times a day to maybe 2 times a week. (We are doing counseling as well.)

If your son does have ADHD, I'd recommend talking to psychiatrist about meds. Some kids have some success with just therapy, but if he has a real problem with executive function, nothing's really going to help him as much as meds will.

Do you have any testing from more recently? It's possible that the testing he did a 4yrs old doesn't accurately reflect his abilities.

Second, it's possible that your DS is just trying to entertain himself. It's hard for anyone, much less a 6yo boy, to sit 6 hours a day five days a week listening to information that you already know.

ADD-inattentive could also be an issue, but I'm not sure if you can get an accurate read on that until you see him in an appropriate learning environment.

How is his behavior at home?

If your library has this book:

http://www.amazon.com/Misdiagnosis-..._1?ie=UTF8&qid=1321918049&sr=8-1

I would check it out. I was starting to get the "ADHD" comments about my oldest daughter and even though we home school, I knew I would have gotten them if she were in school. She would be the "bored gifted" you mentioned in your post. But I figured I should prepare for an "ADHD talk" so checked into it and now have great information for discussion as to why she is NOT ADHD.

He does have inattention at home - he will be so focussed at whatever he is doing or looking at he doesn't notice when someone calls his name, he gets distracted in doing a task and has to be reminded (like "hey, remember to put the other sock on and button your pants"). But he can concentrate on something that he's interested in for hours. Literally. He is a master of delayed gratification (saves money, reward tokens and then allows himself to use some of it when he has reached a goal (like he'll decide to spend 10 of his tokens on an hour of movie time once he's gotten to 200 tokens or only eat 2 pieces of his smarties so he has some for after dinner). I thought kids with ADHD had real difficulty with delayed gratification.

I do plan on having him re-evaluated with someone with experience with gifted kids/2e kids, but we have to fly out of state to do that so it won't happen for about 5 months.

I'm not opposed to meds, just want to make sure that that's the right direction and all other possibilities have been ruled out.

I think I've read every book out there I can find. Misdiagnosis and duel diagnosis is excellent.

Delayed gratifications is typically a difficult concept for ADHD kids, but being gifted allows them to compensate in certain areas. He may not have ADHD at all. Have you looked at the Vanderbilt scale? http://www.myadhd.com/vanderbiltparent6175.html.

While gifted kids exhibit some ADHD symptoms, there are some differences. I see the lack of impulse control as a red flag, personally. "Meltdowns" or tantrums in front of peers with any sort of regularity is a pretty big problem. Does he have these meltdowns in other frustrating situations?

True for comprehension or just decoding? Does he grasp fiction at the same level as nonfiction?


Could well be Asperger's. The irrational meltdowns (intense for no good reason) have been a key problem for my DS9 (AS).

I'd take him to a neuropsych, with a diary of events and a list of the issues you're seeing in hand, and ask them to do a full eval. It is very important to get an outside opinion; a school psych is not qualified to make medical diagnoses.

At the same time, give the list of issues to the school (in writing) and ask them for a full educational evaluation. They'll look at slightly different things than the outside eval will, and you'll put it all together and come up with a plan for school.

If they find nothing but bored gifted, then you haven't lost much.

If he has AS, the fastest way to stop the meltdowns is probably going to be to medicate for the anxiety. We did this in first and immediately got significant gains. We have also used ABA (behavior therapy) to work on coping, and it's been very useful to DS.

We eventually medicated for attention too, but the anxiety was the main driver of the meltdown behavior. AS can cause serious attention problems as well as anxiety issues (some professionals diagnose ADHD on top of AS, some don't).

HTH,
DeeDee

I did the Vanderbilt assessment and he scores high in the screening for ADHD inattentive and Anxiety. It's a nice little screening tool!

Regarding decoding or comprehension, I think it's comprehension. I do get a little confused on what it means that kids with aspergers have great reading skills but little comprehension. DS loves fiction, not long ago read the percy jackson series and made up his own fantasy where he was the 13th greek god (not just a demigod as he would tell me) of immortality who would confer immortality to all around him. He also seems to get abstract thinking fairly well. ...at least I think he gets it. But he definitely has some aspergers traits.

MamaJA, are you living my life? lol!

Same things here...I have my final talk with the evaluator tomorrow, but so far, it would seem more NOT ADHD or other 2e type thing. We are homeschooling now and I'm trying not to kick myself and remind myself that my kids are more resiliant than they often seem...

Also, my DD8 didn't have meltdowns per se, more withdrawl and reading books under her desk. This year she HAD finally started, I guess, to backtalk the teacher, but I'm still not exactly sure how that goes, it was more like openly refusing to do work, just letting it sit there or ignoring the teacher. She generally did not disturb the other students. We got many "possible Asperger's" comments but mostly just based on her desire for well defined personal space and lack of eye contact.

Honestly, I would sit down for a chat with the school and bring those test scores, possibly info from Misdx, if you have it, as to why it's NOT that he is a BEHAVIOR PROBLEM, but likely bored in class. You will probably get pushback about how he is already in the gifted program, blah blah...

Having a child who was labeled a BEHAVIOR PROBLEM myself, these are some of the things I wish we could have tried before I got so mad-changing classrooms, more challenging work, tryout in a higher grade. But our school was having NONE OF IT for a kid they had already made up their minds about

Mine comprehends well, actually, but his fiction comprehension level is more at age level, whereas his nonfiction level is somewhere sky-high, and he sometimes misses social nuances or characters' inner motivations in the stories.

With a gifted AS child, you have to throw out a certain number of the "can'ts" that are often expressed about AS kids. The core problems that affect my DS from his AS are social skills, self-control especially around strong interests, and executive function issues.


Mine has always been highly abstract. More particle physics than Newton.

How are your DS's relationships with peers?

DeeDee

I once tested a middle school student with autism who recognized words and read aloud like a high school student, but answered comprehension questions like a second grader. A big part of the issue with autistic students is that they might answer the first question or two correctly, but later questions are answered out of their own experience or imagination instead of the story.

In general, formal assessments for autistic students are of limited use. You might accidentally find out they can do something you didn't know they could do. But between the accommodations you have to make in order to just get through the test, and behaviors like perseverating during a timed portion, the results won't have much statistical meaning and won't tell you anything about what they can't do.

Regarding social skills, he is behind. Social skills don't come intuitively to him as they do to my younger child. DS has friends - particularly a little girl who is a bit of a tomboy and he seem to get along great and do playdates and hang out together at the afterschool program. If someone else has similar interests to his he gets very animated and engaged, but if there's no one around who's interested in what he's interested in, he's happy to be off by himself doing his own thing.

But regarding unusual and intense interests he doesn't exactly fit aspergers. He does intensely investigate and learn as much as he can about a topic, but the subjects change every month or so (although we do revisit astronomy related topics fairly frequently) and he doesn't generally talk about any of these topics excessively.

I've read as much as I can about Aspergerger's and ADHD inattentive type in gifted kids as well as profoundly gifted kids behavior (not that he has the scores for that). It seems to me that the line separating these diagnoses gets very fuzzy in gifted kids. I do try to keep in mind the DSM criteria for actual diagnosis and I think based on DSM criteria, he qualifies for ADHD inattentive, but not Aspergers....but he definitely falls somewhere on the spectrum, and has high anxiety.


I decided to have him evaluated by someone familiar with gifted and 2e kids (Amend), because it's not my place as his mom to diagnose him (I'm a doctor so I have a tendency to diagnose things on my own).

I really appreciate hearing your thoughts, it helps me clarify my own

DeeDee thanks for the tidbit regarding meltdowns being anxiety related in your son, I think that mixed with perfectionism may be a significant part of the meltdowns we are having.

Good luck with the testing. I know not everyone agrees, but I don't think the official label always matters very much. What matters is finding what works for your kid. Perhaps he does fall on the Asperger's spectrum, but if all he needs is anxiety meds and some counseling to get him to a happy place, that's the primary goal.

What kind of list of issues? my concerns about not ideal situations in the classroom (25 kids, no desks - a little much for a kid with attention and sensory issues), or behaviorial issues I see in my DS that need to improve to function optimally?

What does a full educational evaluation entail? What things do they look at?

We are meeting next Tuesday to make a plan on what to do next time he has a meltdown. It might be a good time to request something like a full educatonal evaluation when we have everyone in one room.

I agree. Labels are useful for funding, for getting services, sometimes directing treatment and for a little understanding from school officials etc. But labels are limiting. They put people in a box and limit what others think they are capable of and that can affect what our children think they are capable of too. That is the dilemma isn't it?

I really appreciate everyone's input Thank you so much!

Mine rotates interests frequently-- I'm not sure if that's a gifted/AS trait or just the kid I have.

I'd say that the special interest aspect can also be expressed negatively: a child without AS can make himself be or seem interested in something in order to get along with others or please a teacher. But my kid with AS cannot feign interest in something he doesn't care about, no matter what the stakes are. We work on this.


If you see an experienced neuropsych who deals extensively with bright kids, they should be able to tease this out for you. It's what they do.

More in a minute on your other post--
DeeDee

The best book for this is From Emotion to Advocacy-- they have sample letters for requesting evaluations.

I'd write a letter to the principal, copied to the district's intervention services/special ed office, detailing the meltdown problem and any other behavioral issues (social, attention) that you see. And ask them for a complete educational evaluation, using the template in From Emotion to Advocacy.

I'd also ask them to take data on the meltdowns in order to develop a plan to prevent them.

An educational eval depends on what issues you are seeing. If his pencil grip were weird, the OT would see him; if gross motor, the PT. For anxiety/behavioral issues there should be teacher and parent survey checklists plus a detailed classroom evaluation. They are likely to do IQ and achievement testing to look for LDs, if there's any indication that might be there.

I'd put the social skills on the list because if it's a real problem, you want to get the school to work on it in an eventual IEP, and you can't get it in the IEP if they didn't test for it. So at this stage you make the list cover everything that you have thought could be a problem.

You're not likely to get much traction on the problem of 25 kids in a class, but you might get him preferential seating and other accommodations.


If you don't make the request in writing, it can be like it never happened. A verbal request has no legal standing. The written letter starts a clock on them to get the job done: I think they have 60 school days, which is plenty long enough if your kid is having meltdowns.


I disagree with this. If you don't know what you're dealing with, you probably won't choose the right meds or the right counseling/therapy help. And that sort of thing matters. Talk therapy is totally ineffective for AS, for instance, but could work for other problems.


My experience says this: it is no fun to have a kid who sticks out because of unwanted behaviors (meltdowns being example 1 on my personal list). On the other hand, it is much nicer to have a kid whom teachers and peers understand and can accept-- he's melting down because of his Asperger's-- as opposed to the non-diagnostic labels of "weirdo" or "from an undisciplined family" or worse, which are applied to these children if you don't offer your community another explanation.

If your DS hasn't already, he will likely soon notice that other children do not have meltdowns, and he does. It is better to have an explanation for him (e.g. "you have anxiety, which means...") than let him think that he's the only one with no self-control, he can't behave, he's a bad person, which is the main alternative message available. The label can offer understanding and empowerment, in addition to services.

I wouldn't worry for a second about labeling my child under these circumstances, which we have experienced firsthand.

DeeDee

DeeDee,

I do really appreciate your thoughts. Obviously you've been there and done it. Without a doubt our sons are very similar! I do appreciate hearing your experiences. I'm looking forward to hearing the neuropsych eval (have been needing to hear it for a long long time). I've worked though enough on this journey to be ok with any diagnosis at this time. I just haven't felt our local psychologist has enough experience with gifted kids to feel that they're the best person to evaluate him.

He already knows he thinks differently than the rest of the kids in his class, but we've really reinforced how that generally is a good thing (at least IMHO as you might guess from my screen name). A well meaning teacher loaned him the book "odd boy out" and for better or worse, it got a discussion going about being different from other kids.

Thanks for the info on educational eval. I'll look into it over the weekend.