Gifted Issues Discussion homepage Forums Twice Exceptional EG boy with possible ADHD - neuropsych eval?

Background:
DS turned 5 in November. He tests borderline PG on the wppsi, and almost as close on the SB-V.

He had a rough first year of preschool in Montessori, and we decided to keep him home this year because he is a Nov. birthday, and according to our state, should start K this fall. We did get him accepted to a gifted school early for K, but it was a 35 min commute, and all day every day K. DS also suffers from multiple food allergies, so that was another big reason we decided to wait. I had originally planned on him skipping K, but it doesn't look like that is an option right now, there are no spots at the school in 1st.

When I learned that DS would need to start in K, I had all but decided that we would just keep him home and home school him for the foreseeable future.

On Thurs, DS had an appt with the psychologist, who told me that homeschooling would not be good for him and that we should consider medicating his ADHD before even starting kindergarten to "save his reputation."


I didn't ask why he thought homeschooling would be bad, I was too focused on the medication discussion. My DS is borderline ADHD on his worst day, most that know him don't even see a problem. It's just his teachers from last year and I that noticed he has trouble focusing for any length of time. He still has trouble, and some symptoms, but I'd at least like to give the kid a chance to try school without it. (He isn't hyper, he most likely has the ADHD-Inattentive) We filled out the diagnostic questionnaire and DS did have mostly 2's and some threes. 1 or 2 "0's." LOL

I'm guessing its a "socialization" argument, which to be honest doesn't really hold water with me. DS would be in different grades for reading and math ideally, and he would have to sit alone at lunch because of his food allergies. And lets not forget all the parties and activities he will be either left out of, or feel left out of.


We've been working on at least a 1st grade level already, I have this horrible feeling that he will go, be bored and act out, and then I will hear that he needs medication.


I have nothing against medication, I was just surprised that the dr would suggest starting it before school. DS's problems don't seem to be that limiting, but I guess I'm no expert.

What I'm strongly considering is getting him a neuropsych eval. The psych we see now kind of dismissed the accuracy of testing for ADHD, but I'm pretty nervous about medicating on just a checklist.

Any tips or advice?

Comment removed due to lack of factual relevance.

My DS11 was diagnosed with ADHD by way a super-expensive neuropsych battery after K. I, like you, did not feel comfortable medicating him without a thorough investigation and expert medical opinion. I can't tell you if it was medically necessary but it was necessary for me. You will also have a certain amount of people judge your decision to medicate, if you do, and having a thorough work up from a board certified pediatric neuropsychologist tends to shut them up.

I can tell you based on our experience that the increased impulse control that the medication provides will be helpful for your DS socially, especially if he will be with older kids How a child interacts in a one-on-one homeschooling situation or with adults is quite a bit different than with peers in a school setting. Generally ADHD kids are "asynchronous" socially and will struggle with peer relations under the best of circumstances. My DS has been in counseling for being bullied and received social coaching with a different counselor because of social struggles at school. Adults love him because he is so very witty and clever with them, as well as being a sensitive and kind little guy. It's just the other kids!

In sum, don't ignore the social considerations of treating ADHD. Your gifted DS will likely find his peer relations the hardest part of school.

oops, Sorry for not clarifying, it's actually a psychologist.

Hi,

Your son's situation sounds similar to ours in some respects. We are still in the early stages of figuring things out so This might not be much help but i figured worth mentioning just in case . Our son tested PG, after we initially went in expecting a diagnosis of ADHD. We have also found that many friends and people we know see almost none of the "challenging/inattentive" behaviours that we have noticed. But like you, teachers and caregivers have always picked them up.

We recently had him tested by an occupational therapist who diagnosed him with a sensory processing disorder. For us, it has been at least one of the missing pieces of the puzzle. He has a mild auditory filtering issue which causes some of his inattentive behaviours, so we have learned some specific tips and tricks for use at home and in preschool. We are still learning, but the sensory related therapies have certainly had an impact on our daily lives...in a good way!

I am not opposed to medication for kids who need it, but I also don't agree with medicating just based on a checklist. I think the guy doesn't know what he is talking about, and if homeschooling is working, then I would stay with it. Check out the accelerated learner board at the Well Trained Mind forums--if you want support/experiences with homeschooling that could be useful.

I would get the neuropsych eval - it will give you a good idea of what exactly is up with your ds, which is important to have, particularly if you have any doubts about the ADHD diagnosis.

FWIW, my dd10 has multiple x multiple food allergies - back when she was 4-5 years old and we were still figuring out what her full list of foods she was allergic to was, she had a very tough time focusing. Allergies aren't her only challenge, she also had visual processing challenges and is very sensitive hearing, but the food allergies absolutely impacted her ability to concentrate... as well as... there are foods contained as inert ingredients in many medicines and she ultimately had to start having her meds compounded. Sooo.... just something to consider, do you think you're at that place yet where you really have a good idea of his full list of allergens or is there a chance that there might be something still in his diet that's impacting his ability to concentrate? I'd really want to know that before starting any kind of meds.

I also was wondering why your ds would have to sit by himself at lunch at school? Wouldn't the school be able to make arrangements such that he could have an allergen-free table and have other kids sit with him? Our dd has gone to public school since kindergarten and preschools before that. Advocating for kids with allergies can be a lot of work, but it's also something that you can usually advocate for successfully. There are more and more kids with multiple food allergies each year across the US.

Best wishes,

polarbear

You know, it's always a mystery if we have found everything or not. We just found out recently that he has oral allergy syndrome, so it's not out of the question that something else is causing a reaction. Although his list is about 15 foods, so if it is food related, I may lose my mind.


As far as the sitting alone, DS is contact sensitive to many things. The school feels it would be best if he were to sit by himself. I'm guessing I could push for something different, but honestly I'm not sure how safe I would feel.

My DH and DS have ADHD, and I wouldn't start down on the medication roller coaster unless you see it's totally necessary.

Medication can be amazing for a child or adult with ADHD, but there can be a lot of trial and error... And the errors are a b****.

I definitely wouldn't go through all that if you aren't seeing issues that are impacting his quality of life.

The neuropsych eval sounds like a great idea.

I would go with "when in doubt, throw it out" regarding the meds. You need way more time and investigation. And if your DS has so many sensitivites, chances are the med road, if you do take it at some point, will be especially experimental. I've never heard of such a thing, a little child that age and a concern of needing to "save his reputation". How unforgiving. Pre-emptive medication behavioral management, "just in case"?

Regarding the homeschooling and socialization, if you haven't already, you might want to try googling/reading articles about "socialization versus social development".

A little kid sitting alone at lunch is not a heartening thought, and what about bullying? Who is really watching these kids...at my DD's school there are 2 monitors for over 100 kids in the cafeteria, the teachers don't stick around. A little kid sitting alone is an invitation for trouble, if not just a very lonely introduction to big school. I would totally understand your worries and would understand you'd rather have him alone that vunerable to allergic reaction, but wouldn't there be anyone else for that shift from another class with allergies too? It seems the further we get from our food source and the more corporate it becomes, the more children have food allergies.

And you're really very clever to consider the birthday party/treats/snacks issues. That's a big part of kindergarten, especially!

If you could homeschool while you investigate things more and send him to classes at places that are more sensitive about such things, or sort of work around the whole food thing due to scheduling (like, after school classes) he could have the experience in the coming year of being with kids his age or age range but being safely at home for "differentiation" and the food issues.

I've noticed lately through "playground talk" amoung parents that there is a little trend of psychologists who don't do neurophysch exams really discouraging their current clients from pursuing neuropsych exams.

...