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Glad you're back with an update, lulu!

Several factors can affect how his test scores have unfolded over time, not least of which is overall development and increased testability. On the whole, however, his current resutls are quite consistent with his past resutls, with strong verbal and fluid reasoning, and working memory (the major change), and high average visual spatial reasoning and visual-motor processing speed. The increase in his working memory scores could have something to do with medication, since that's mostly a test of short-term auditory memory, but it could also have to do with development and strategy use. I notice that his visual working memory must have increased as well, with performance probably somewhat impacted by development in motor skills to grossly within normal limits. (No fine motor is involved; it's purely pointing. I'm also curious if he was tested using an iPad on any round of WISC or WPPSI testing, as there are some differences in PSI performance depending on whether the examiner used paper or tablet for those measures.) Visual spatial thinking measures probably benefited from one of the tasks being motor-free (in contrast to the WPPSI). There is an option for a motor-free VSI, if the examiner has access to the WISC-V Integrated, which might have been an interesting comparison, given the huge gap between VS reasoning and motor coordination. (I.e., it is possible that his actual visual spatial reasoning is on par with his verbal reasoning, but is underestimated on formal testing because of interference from his weaknesses in motor coordination.)

In keeping with cautions emerging from his early testing, I see that dysgraphia did eventually warrant a diagnosis.

ADHD is typically diagnosed based on multiple instruments, and having some medicated and some unmedicated isn't necessarily a bad thing, as long as you know which ones are which, and depending a bit on which ones are unmedicated. The achievement testing is not usually a critical component of the ADHD diagnosis. That was probably more relevant for dysgraphia.

Welcome, Kim!

Every child of whatever description is unique, so please keep in mind that my thoughts and suggestions are in the context of my own experiences, and that you know your own child best. But, fwiw, I am very much in favor of allowing children to learn in joy. He is still very young, and his imaginative play is entirely age-appropriate in some ways (although to a much higher degree of complexity and sophistication than many of his age-peers, in keeping with his cognition). Will he eventually need more academic advancement? Most likely, but as you report, when presented with academics, he quickly picks them up. As long as you maintain a rich, interesting, intellectually curious environment around him, I suspect that he will show you that he is ready and motivated to engage in more formal academics. It may be that his school is currently sufficiently engaging and satisfying to him intellectually because he is busy developing other important aspects of himself.

I have frequently mentioned in these pages that my criteria for appropriate educational decisions are that my children feel loved/are loving, are happy, and are growing as whole people.

Let me tell you a little story: One of our children is fairly gifted in music as well as academically. As a preschool-age child, DC requested and then raced through many early academic workbooks, reaching an end of kindergarten/beginning of first grade (so about age six) level in reading and math by age four. That fall, DC started play-based preschool a few mornings a week, and abruptly lost interest in academic workbooks (although DC did create a number chart 0-100 for a classmate, to "help" them learn their numbers!). Instead, DC became fascinated with making books, which encompassed cutting paper to the desired size and shape, coming up with ways to bind them (lots of tape, staples, and one request for a parent to sew), writing and illustrating. This lasted for about six months, before DC spontaneously returned to interest in formal academics.

At the same time, DC had a long-standing interest in playing the piano, singing, and writing songs (for both), but expressly refused to take piano lessons from me; I was firmly informed (by DC) that DC would accept instruction at a very specific age. On that exact date, we started piano lessons, and continued consistently until DC turned 13. At that point, two things happened more or less simultaneously (leaving aside, of course, that DC also became a teenager, which is hardly insignificant!): piano lessons stopped (due to DC's lack of interest in classical music and formal instruction), and DC also stopped doing certain academic subjects. By then, we were homeschooling, so both of these were probably related both to DC's internal developmental process and to the interpersonal developmental process between parent (me) and adolescent child (DC). For the following six months, DC did almost no academic work in the math curriculum, and, in fact, ended up taking two and a half years to (not quite) finish the next year's worth of the precalculus syllabus. OTOH, DC spent many hours each day, unprompted, at the piano, writing original pieces, learning songs of personal interest by ear (and occasionally even working them out from sheet music), and making huge leaps in pianistic and musical development--but on their own terms, and on self-selected content. After about a year of independent piano studies, DC requested piano lessons, with the specific goals of learning to improvise effectively from chord charts, and of learning to sing and play at the same time. We found an instructor and provided those lessons for a year (until the teacher moved away), after which DC dove back into academic math.

Fast forward a bit, and that child completed university one year early for age, summa, with double degrees including a STEM field, and is now thriving in a highly-selective doctoral program. Music and composition continue to be major parts of DC's life.

All of which is to say that it is quite possible (even expected, in some cases) for a gifted child to allow certain areas to lie fallow (so to speak) for a time, perhaps while they are diving into another area of interest, and then to pick them back up when they are ready, and quickly absorb those skills and concepts. Could we have pushed formal academics more? Certainly. But it's hard to imagine generating better nominal (long-term) academic outcomes than the ones that actually resulted, and even if it were, the possible costs in self-motivated learning, creativity, joy, and possibly our parent-child relationships were not something that we were willing to assume merely for any incremental benefit in year of graduation or additional degrees earned.

So while -- as for any parenting decision -- there may be situations where you need to make choices on behalf of your child, when he cannot see his own best long-term interest, or doesn't know the entire range of options, I think you will find that your knowledge of your child will show you when he needs more structured instruction, and when his interest-led explorations are sufficient.