He said that the thinks DS needs a very structured environment with a no nonsense you have do do it even if you don't want to attitude (in a caring way of course). Which is pretty much how I handle him at home so that part at least sounded right to me. But it just seems like the testing only scratched the surface and left me with more questions than answers.
I would be very careful not to make assumptions about the type of learning environment or an ADHD diagnosis without further testing to tease out why the coding, symbol search and letter-number sequence scores are relatively low (coding in particular). Your description of your ds...
"DS hates to write and has horrific handwriting. I have seen perfectionistic tendencies and anxiety issues with being right, and worrying over things he can not help."
... matches the exact description I would have given you of my ds at 8, prior to his dysgraphia diagnosis. My ds was also suspected of having ADHD by his teacher, who was used to seeing students with ADHD but had never heard of dysgraphia.
It's really difficult to get to the root of what's up with students with behaviors that signal something is up and test scores that are scattered all over the place - the challenge is that there are overlaps of symptoms among ADHD and LDs and other challenges. In spite of that, the test scores you have are giving you quite a bit of information - the key is to get the follow-up testing that will help make sense of the scatter.
For instance, coding involves making a mark in a certain direction and it's a timed test. Skills involved include the ability to hold a pencil, to control the fine motor connections between brain and fingers, the ability to see the symbols clearly, and more. So a child who can't well might score low, a child who can't control finger motion might score low, and a child who just wants to be sure he makes nice-looking marks therefore takes his time might score low. Our neuropsychologist ran two types of tests as follow-up for a low coding score: a test of visual-motor integration, and a finger tapping test. The visual-motor will help show whether or not there is a visual challenge or fine motor, and the finger tapping test relates to fine motor.
Our neuropsych eval also included a specific test of attention (on the computer) as well as executive function testing, behavioral surveys filled out by parents and teacher - these were used to determine if our ds had ADHD. He came in borderline on his first eval, primarily because his teacher's behavioral survey strongly suggested issues with attention. Our parent survey didn't, and we didn't see the problem at home. I understand that as parents we might not see the forest for the trees, or that we may be scaffolding our children's home environment in a way that supports a child so that ADHD symptoms don't arise at home - but a key part of the diagnosis is that the symptoms occurred before a certain age and that they occur in more than one setting. If you haven't seen ADHD symptoms in other places (scouts, sports, church, whatever) and you don't think you're seeing them at home, it's possible what looks like ADHD could be something else - especially when you see that type of scatter in scores.
One other thing a neuropsych eval typically involves is a parent interview which includes a full development history (from infancy), questions about current functioning at home and at school, and a look at examples of classwork etc. The parent interview revealed key things in our ds' early development that we'd simply thought of as cute quirks (very late talker, didn't crawl etc)... and yep, those may be cute quirks for a lot of kids, but the neuropsych was able to put together those along with the test results and watching ds write etc. and pull it all together in a way that made sense.
And... I hope my reply made some sense!
Best wishes,
polarbear
