Gifted Issues Discussion homepage Forums Twice Exceptional ADHD/ADD Question

marytheres, your notes about preschool reminded me of another thing - it's been really interesting as my ds gets older because he can now express his thoughts, feelings etc that he didn't really have a way of doing easily when he was so young, so we now have a lot more knowledge of how dyspraxia etc impacts his life. Anyway, your remarks about preschool reminded me of something my ds (now 13) told me just the other day when we were getting ready to go to school and he was putting on his coat. He went to a Montessori preschool where they were encouraging the kids to learn/do things independently from a very early age, so they taught the kids to put on their jackets by laying them out on the floor sorta-upside down, then putting their arms in first and flipping the coat on over their head. DS told me he was so glad that they did it that way in preschool because that way he knew how to put on a coat when he got to elementary school. I know that probably sounds like nonsense or "what's the big deal" to anyone who has an NT child... but things like that are a big deal to kids who don't have the same whatever it is that connects brain to muscle movement. He said he was still putting on his coat the Montessori way well into 2nd or 3rd grade, while the other kids seemed to come into kindergarten just naturally understanding how to and capable of pulling a coat on the regular way.

Which leads to another thing he used to have a tough time with (now he's just slow at it :))... buttons and zippers and changing clothes. He absolutely hates changing clothes because it requires a lot of effort. If only my fashionista dds who used to change their clothes every 10 minutes had a slight tad of dyspraxia lol! Anyway, in addition to ds not liking changing clothes at home, in early elementary he was always struggling with getting ready "fast enough" to get outside with the other kids in class - his teachers used to think he was dilly-dallying at his cubby in the morning when really it took him a long time to get his jacket off, and at lunchtime he used to purposely put on his snow pants etc *before* he ate so that he didn't miss out on any recess struggling to get them on (recess was after lunch). The other kids all took their snow pants and jackets with them and left them on the floor next to where they were sitting while they ate then put them on when they were done. FWIW ds never had enough time to finish his lunch either... ok... way more info than you need on my ds lol!

I think you'll be glad you pursued the neuropsych eval - I wouldn't anticipate you'll have all your answers to everything, and I'd guess you'll probably come away with even more questions... but the info you get will definitely be worth the time and expense.

Best wishes,

polarbear

Polarbear - I looked up symptoms of dyspraxia here: http://www.dyspraxiausa.org/symptoms/early-symptoms/

And DS had none of the first 13 early symptoms... He has many of the others but the symptom "Lack of Imaginative Play," he definitely did not have ... In fact, pretty much all of his play was creative and imaginitive. It was his absolute favorite form of play from as early as he could actually "play." I spent countless hours as Ahsoka (our dog was Java the Hut) and DS was usually Anakin.... He LOVED dress up. I had to go out at Halloween time and stock up on costumes because I could never find dress-up clothes for boys any other time of the year and he loved them! I can't tell you how many times I had to answer the door in a power ranger or in a Star wars costume becasue we had to play dress up. He will pretend anything is something else to suit his imaginitive game - e.g., our bowling pins were often meteors or rockets. For years his action figures were his favorite toys (he still likes them) and he would play imaginitive games all day with them.
Did your DS not do imaginative play? He also is very cautious and dislikes leaving any tasks unfinished. Once he starts he likes to finish. he also always loved Legos but he never did care for puzzles... until recently now he likes them a more.

Anyway, perhaps that is why dyspraxia never really came up. He has many other symptoms though and he sounds a lot like your DS. So perhaps if that is what is going on he has only mildly.

It doesn't answer the bigger overarching questions, but with strong creativity and visualization I'd try mental walking paths techniques for task/sequence memory. Presuming he is good at navigating? If he can vividly walk through your house in his mind, he can build a visual map of specific locations in that walking sequence.

Such as: I walk past the table in the foyer, to the sofa in the living room, to the dining room table, to the counter in the kitchen, to my desk in my bedroom. Or such. Then if he needs to remember a sequence of activities, he visualizes each item into each location like:
1) Get Dressed
2) Eat Cereal
3) Drink Milk
4) Brush Teeth
5) Comb Hair

Becomes a:
1) A pile of clothes on the foyer table
2) A box of favorite cereal sitting down on the sofa (with a remote control in its hand?)
3) A cow standing on the dining room table
4) A wind-up set of teeth bouncing around the kitchen counter
5) A giant magenta wig on his desk

I'm a fan of leveraging strengths.

Oh Nice! Creative I like it... It's worth a shot.

Cool. I can't take credit for it; I learned it 25 years ago in a cognitive psych class. And it goes back a couple thousand years more and is also known as Method of loci or Memory Palace. http://en.wikipedia.org/wiki/Method_of_loci

I'll be curious if it works for him as it may play right to his strengths. Making interesting pictures is an important part of it. Around 10 locations is a good start and the same path can be used for different lists. I find it easiest to briefly close my eyes as I put something in place. I taught it to my DS7, and he was surprised when he remembered 9 of 10 things I had him place the very first time.

MaryTerese just popping in to ask whether I know why the meds appear to held DDs low tone. I don't think they do exactly, I think they help her slow down, think, pay attention and better integrate her mind and body.

When she had her last OT eval (a year ago at 5.5) the OTs advice was that her neurological functioning (in so far as OTs assess it, so I guess applying to controlling her body) was inline with her IQ (3SDs above) and was the only reason her significant low tone and hypermobility were not more obvious. He was astonished by some of the things she could do (monkey bars for example), which he said should not be physically possible, and put it down to a) determination and b) exceptional ability to control her body with her mind despite her physical deficit. And certainly she exhibited this extreme determination to achieve things with her body from 2-3 months old and would work and work and work until she could do what she wanted to do. From my perspective the ADHD medication helps her apply this level of attention to physical tasks that are not fun, engaging or interesting to her and thus bring her ability to control her body while handwriting or having her hair brushed in line with her control when doing monkey bars... Or that's my personal theory anyway...

That said, I am part of a gifted / learning delayed group and I know many many parents find their child's other co-morbid issues are vastly improved (sometimes to the point of being undetectable) by medication for the ADHD. Our paed is certainly of the opinion that a lot of conditions often see with ADHD are symptoms of that global neuro-developmental delay, more than standalone conditions, and does expect them to improve with treatment of ADHD. CAPD in particular is one that every paed I have spoken to does not consider to be a standalone but merely a symptom that should either disappear or radically reduce with medication. DD still chooses to wear her glasses on medication and they do help so clearly her visual integration is not completely improved by medication.

So interesting! Your DD sounds like an amazing girl! How severe is her hypotonia? The hypotonia is a bit of a mystery to me... When I took DS to the neurologists a few months ago after his initial assessments almost about 2 years prior, they were also a bit amazed at how well DS was doing. They said that they honestly would be on the fence about giving him the diagnosis now. I was thrilled but also perplexed as I had always been told that it was not a disorder that one grows out of... They didn;t really an offer any reason as to why they just said "be happy!"

My DS did super well on his tests of auditory processing skills - scoring in the high 90th percentile for all of it (mostly 99%s) with the exception of the reversed digit test. So I supopsoe auditory processing is good .

But he scored quite poorly on the CVLT, which pains my heart.... I am no expert on any of this stuff but it stuck me as I was reading like it's as if he been brain injured or something The report said a lot of things regarding this tests I didn;t quite understand, though. However it was clear he scored low average on parts and extremely low on other parts of it. It did warap it up by saying it doesn't look like DS has a problem encoding the information - he has a problem witht he retrieval especially when there are no visual cues.

Anyway, just rambling.. I guessthis stuff will mean somethign to a neuropsych

Watching a 6 month old essentially do pushups for 10-30 mins at at a time, many times a day, was certainly entertaining :-). I should find the photos to figure out exactly how old she actually was, might have been more the 4-6 month old window.

I haven't been given a measure of how bad her hypotonia is, given she's mostly coping. She spent most of last year writing with a hard brace holding her thumb in place, massive pencil grips and special paper. On medication she has been fine without the brace. And the teacher can tell when she's on or off medication from her handwriting, as can we, if it weren't obvious from how far off with the pixies she is.

Strength helps low tone immensely. And she's surprisingly strong... OT was very surprised by how strong her grip was using a grip strength measurement tool, given how week she is. Which would be why she can do monkey bars.

marytheres, when you say he did well on auditory tests do you mean that he has been tested for CAPD? Or that he did ok on Auditory parts of the WISC? Not the same thing... My other DD actually does have CAPD, she has a major weakness in WM but did fine on many auditory parts of the WISC. Even on the CAPD testing she had some scores in the 98th - but she also had the requiste two related areas below the 2nd... And on her recent CELF4 she has scores spread over more than 4 SDs... Some kids are very very hard to peg...