Gifted Issues Discussion homepage Forums Twice Exceptional HELP re P/T conference tomorrow!

Thanks Blackcat... He has not been offcially dx with ADHD. So I couldn't even start meds yet anyway. I do think if I pushed harder and got the teachers' to do some rating scales (they did not when he was eval'ed last time because it was summer and he wasn't in school), he would be officially dx'ed. I know that the last eval they did *some* tests for it but they didn't bear out the diagnosis -I know one was a computer test (?), and there was some other assessment that he actually did really well on (shockingly) I forget the name but when I am home I'll look it up. Also, his working memory doesn't really fit the bill for it either. The tester and I talked about it and she did recommend coming back for some additional tests, getting his teachers' feedback and she would also need to do an in-school observation of him. At that point she could (and I think would) give him ADHD diagnosis. I'm sure he'd get it - especially the way the teachers were talking today. However, I am still personally not completely convinced that is really what he has; so, even with the Dx I still would wait on meds anway.

Part of what is also affecting my wanting to wait on the meds is this: my mil brought me my DH's progress reports and all of his notes home, etc from when DH was in elementary school; for the first four years or so of DH's life his report cards and notes home were filled with the exact same sort of complaints about DH's attention that I am hearing now. FIL said he wasn't concerned b/c he reports he also had the same issue when he was in elemetnatry. Both FIL and DH report that they "grew out of it" at the start of middle school (DH was even accelerated in middle school). Both went on to college and then post-graduate degrees. I chatted with the psych about this trend and she said it is certainly possible that there is just genetically delayed development of the frontal lobes. [DH also has dysgraphia and we suspect FIL does as well.] Anyway, both are fine now. And my DH does not seem to me to be an adult with ADHD at all (although muti-tasking still does not seem to be something he can not do well, LOL). MY FIL is the same - he's not a adult with ADHD. Both are organized and on the ball completely. My twin brother, however, DOES seem very ADHD as an adult and probably has been pretty severely ADHD all his life. He was very unsuccessful in school and did drop out. Presently, he is also successful n(finished school, went to trade school, and has his own business; he's actually a work-a-holic even though his whole life he was called "lazy" ) but just a few hours around him and he really does seem very adhd (and he is not medicated so that's why it's really obvious).

So, anyway, I want to hold off on the ADHD medicine route until I 'really know': is this somehting he'll grow out of like my DH and his grandfather? Or is this the life-long ADHD like my brother probabaly has? Both psychs (school and private) seemed very supportive of holding off on meds - especially since it si not affecting his success at school (grades) yet. But they did say they are open to whatever startegies and accommmodations I can come up with to help in the meantime. And, hey, if they are so willing to do whatever will help and support - I got to appreciate and take advantage of that!

Geofizz, thanks! I was posting when you were posting I think... Most of the answers to these questions are contained in my last post. DS just turned 8 - he is in 2nd grade. Yes, as I mentioned in my last post this is a bit of a change.

The disabilities that put him the category of 2e are Ehelers Danlos (genetic connective tissue disorder affecting his joints) and Developmental Coordination Disorder with dysgraphia. I have always suspected it's the DCD that makes him seem ADHD - they do seem to overlapping symptoms, particuarly with the problems dysgraphics/DCD people have with sequencing and attention. But people just aren' as familiar with DCD.

See, this is exactly my suspicion of what really is going on. But I sort of have to wait and see - is this it and he will "get better"? or does he have the real deal and physically needs meds? I really think I do have to wait and see, you know? Thanks MON!

In meantime... I guess we need to do something....(and I need to get the offical Dx just in case we need to try the meds).

Irena, I didn't have a chance to see your email to the school last night, but wanted to let you know it was great! Also glad to hear it was just routine, and that you were able to have the conference.

Re the concerns about attention - were the teachers specific in giving you details about when your ds has a tough time staying on task or was it expressed as a general concern? I would want specifics - so you can see if there are any consistent patterns - is it happening when the teacher is talking to the class and students are supposed to listen, is it happening when he's given a writing assignment, is it happening in circle when a story is read, etc. I would also want to know specific details about what behaviors are being interpreted as lack of attention. Is he fidgeting, looking around the room, getting up from his seat etc.

Next step - look through all the details and see if anything you're seeing is a pattern related to either a part of class where he is potentially bored or a task that is related to his disabilities. I would also try asking your ds what is going on during those times - he's still really young so his feedback might not make sense, but otoh, he might have some good insight for you.

After that - if you have concerns at all (or if you think you need to head off concerns on the part of the school re ADHD) I'd consider doing two things: The first thing I'd do is get a private ADHD eval through either your ped's office or whoever they recommend - this would be an eval that includes behavioral surveys completed by teachers and parents. JMO, but I'd want this so I had a good understanding of whether or not what the teachers were concerned about is really ADHD or behaviors that look like ADHD but are due to other situations such as lack of challenge or improperly accommodating for 2nd e etc. If your ds does *not* have ADHD, it's also good to have the medical non-diagnosis so that if it's raised as an issue at school you have a report stating that no, it's not an issue and not a reason for the distractibility in the classroom.

The second thing you can do is to request a Functional Behavior Analysis through the school - I'm wondering if they ever did this as part of his IEP eligibility process? Certainly if the staff is raising issues about distraction you can use this as a reason to request the FBA. I don't know that I'd do this first - jmo, I'd go for the private ADHD eval first simply because I'd want my ped's opinion (btdt).

I've been in a similar situation with two of my kids - my EG 2e ds and my non-2e MG dd. Two different situations, both suspected of having ADHD, ds does not, dd I thought didn't for a long time, but now that she's hit middle school I'm starting to wonder again. This may get a bit long, so feel free to ignore, but here's what we found in early elementary with distraction (for them) and how we handled it:

DS - his teachers first mistakenly thought he had ADHD in 2nd grade, before we knew about his 2e fine motor and writing/expressive language challenges. We were told he was not focusing in the classroom, staring off into space while the teacher talked to the class, not writing when he was supposed to, and not participating in group activities in class. All of that was actually happening, but it was all related to his handwriting and expressive language challenges. When we asked for specific examples of not participating in group activities in class, for example, the teacher gave us specific examples, and we asked our ds about them and what happened, and it always had something to do with the group having to contribute ideas by writing them down on paper and ds didn't know what to write - which was due to his 2nd e. What we did: changed teachers once we had his neuropsych 2e diagnosis - plus gave ds help with writing (in the classroom during writing time) and gave him access to keyboarding in place of handwriting. With his accommodations in place and structured help with writing assignments (getting his ideas out), the behaviors that were being interpreted as distractibility and ADHD symptoms went away. Over the years, with accommodations and appropriate remediation, it's become quite clear that ds doesn't have ADHD.

DD couldn't sit still in early elementary. She's a sensory-seeking child and she was extremely sensitive to background noise when she was young. She also had vision issues that we didn't know about at that time. She looked like she had hyperactive ADHD because she didn't sit still. When we talked to her about school she complained that she couldn't hear the teacher because of all the noise the other kids were making moving their chairs or tapping their pencils or walking around in the classroom etc. She went through an OT sensory eval and a listening therapy program for almost a full year, and that really helped her a lot with being able to tune out the background noise, and in turn she started being able to sit at her seat and focus on her work, both at home and at school. It was really, for her, a dramatic difference, and dramatic enough her teacher was very very impressed with the difference in just the first few months of her therapy. At home, we saw her sit down and enjoy working on workbooks, worksheets etc right away - for the first time ever in her life. At the same time, at home, if we were to give her a multi-step direction such as "pick up the book and take it to your room" she could not carry it out at all. Ever. She is a happy-go-lucky personality so what we would see looked like an easily distractible kid. She'd pick up the book, stop 10 steps away to notice something else, go to some different room and notice yet something else, drop the book before she'd gone on to the next distraction etc. Looked very ADHD. Turns out she was having severe double vision and after going through VT she had no trouble with those multi-step directions. So once again, we were fairly certain she didn't have ADHD. Another thing she used to do - she had quite a few medical issues as a young child, so she was seeing several different types of drs frequently - and whenever she was in a dr's office she would literally bounce off the walls, she'd be so incredibly hyper. Eventually she told us she "bounced" at dr's appointments because she was scared and worried and didn't want to get shots etc - so basically, she was nervous and it came out in hyperactive behavior that looked like ADHD.

Soooo.... lots of things with dd that looked like inability to focus, easily distractible, and hyperactive behavior, and none of them were due to ADHD. BUT - here's the thing - she's old enough now, in middle school, that she can clearly explain to us how she feels, and now, we're starting to wonder again (as well as she's starting to wonder) if she doesn't have ADHD - she tells us it's a lot of work to focus and she is nervous if she can't move her body - she tells us her body just wants to get up and move around. Soooo... it's all such a puzzle really!

The last thing I would consider - and another piece of the puzzle that I feel is important based on my own children's experience - is the classroom environment. What is the behavior of the other children in the classroom? And is it a noisy classroom where the kids get up and move around a lot, or is it a relatively quiet classroom where the kids are all working in sync and there aren't a lot of disruptions? Do the kids sit at individual desks or in groups at tables? My kids started out at a school that was very project-oriented, student-led learning etc - and the classrooms didn't have desks, they just had tables with groups of students sitting together. Each year there were usually 2-3 students in each class who had challenges that were significant enough they took quite a bit of the teacher's attention to control behavior. At the school they are in now, the classrooms are a bit more traditional in that they have more structure to the lessons. The students still don't sit at traditional desks and they still do a lot of group work - but the teachers seem to have a much better sense of how to engage the students as a group and how to deal with students who aren't staying on task without distrupting class for the students who are on task. I'm not sure how to explain it - but the classroom environment has made a huge difference to my kids' overall enjoyment of school, which has helped my dd in particular really get engaged and improve her school performance.

Last quick thoughts - I'll second the suggestion above for headphones and possibly an mp3 player if that's allowed. My ds uses noise-cancelling headphones at home when his sisters get too loud while he's doing his homework (I suppose we're beyond pathetic when it comes to having to provide ds with accommodations for his sister's behaviors at home lol!). Our early elementary classrooms also had fidgets at each table for any of the students who wanted to use them to fidget with. When my dd used to want to get up and mover around during class, having one of those air-filled gnarly-looking seat cushions helped her. I am guessing with your ds though it's not so much getting up and moving around as it is holding his attention and engaging him.

polarbear

I'd say this was definitely true for our 2e ds - plus another thing that happened with our ds was his working memory score on the WISC actually improved between 2nd and 5th grade (considerably). His neuropsych said that's not all that uncommon, that working memory is the one piece of the IQ test that she sees improve sometimes as children mature, particularly as they approach middle-school age.

FWIW one of the things that our ds' teachers felt was a symptom of ADHD for our ds was an extreme challenge with organizational skills when he was in elementary school. Homework went missing all the time, even with tons of prompts and repetition of what-to-do-to-turn it in and a ton of oversight from teachers and parents. In hindsight, I am fairly certain a lot of the disappearing homework was tied to frustrations ds felt over his 2e challenges - he wasn't able to produce the quality of work he saw the other kids producing. He was frustrated. And he was definitely organizationally challenged on top of it - but he has worked through to the other side and is now a reasonably well-organized student who cares a lot about his work. I think there were three essential parts to how that happened - having someone (me) walk him through the steps repeatedly for a long time, having his 2e written expression challenges appropriately accommodated and remediated, and maturing.


You don't only have to wait and see - you can have an ADHD eval by a trusted dr. The thing I'd want to be sure of though is that whoever you go to for the eval also is open to the possibility of it being something other than ADHD. It was helpful for us to have a dr do the eval who also had children of his own who have LDs and who realized that an intellectually capable child could potentially be bored in the classroom. We found that in talking with teachers at school, there was a slant toward thinking all behaviors pointed to ADHD simply because they weren't used to looking for LDs in bright students.

polarbear

I have to apologize - I thought I read all the replies before I replied, but keep finding replies I didn't read.. so I'm answering out of order!

Anyway, given this, I might go back to his neuropsych for the follow-up that she suggested .. but.. the one thing that I think is missing here is - an ADHD diagnosis can't be given based only on symptoms being present in one environment (the classroom) - they also need to be present in the other environments a child is in (home). So you and your dh would also need to have filled out behavioral surveys indicating you're seeing behaviors that are symptomatic of ADHD. And I *think* I remember (but can't remember for sure if this is necessary for diagnosis) - but fwiw, our ped felt that another flag for us that indicated our ds didn't have ADHD was that the behaviors that were of a concern re distractibility etc did not occur before he went to school - we were told that if it was ADHD we would have seen signs of it when ds was younger. Instead, we were seeing behaviors only at school and the reason for those behaviors was due to what ds was being asked to do at school (the combination of working without help for his 2nd e and being bored with lack of intellectual stimulation).

I also would consider - perhaps the reason your dh and his relatives had issues with distraction etc in school in the early years might also be due to having been bored and/or dysgraphia etc.

polarbear

DS just had evaluations by the both the school and the neuropsych. He came out fine for ADHD but somewhat impaired for executive functioning--remembering what he's doing, being organized, etc. He has developmental coordination disorder and it's one of the symptoms. So at first everyone suspected ADHD, but his attention is just fine, he's just organizationally challenged. There is an inventory that you and the teacher can fill out for executive functioning as well as one that looks more at ADHD.

Thanks Polarbear. ... Well I have digested the info given to me at the conference and your posts as well as the other posts here. And I really do not have a clear understanding of what is going on at school with regard to specifics of attention.

I am thinking of requesting another conference, just like the one I had on Monday, with the same teachers - only this time I am prepared for what I am going to hear so I will be more prepared with specific questions. Also I want more time alotted for it so we can really disucss this without a big time crunch. And I want my husband there b/c he needs to hear this stuff too. What do y'all think? That's appropriate, right? For my husband, imo, it's different just hearing it from me than hearing it while sitting across from five teachers. Also, he usually doesn't say too much but occassionally he really does have good insight and has good questions...It would be nice to be able to discuss this together with him having first hand info.

I am also annoyed that when I brought the issues of him possibly being bored/disengaged I was immediately shut down by what I felt was a rather offennsive comment by the Gifted teacher in which she stated that "DS knows that if says he's bored everyone jumps." First of all, the gifted teacher has only had DS in her class (which, by the way, only meets for an hour twice a week) for one month so how would she come to this conclusion; secondly, Ds has been complaining that school is boring for about three years now and no one has ever "jumped" that I have noticed... Usually it is completely brushed off. So, where is this perception coming from and why does she have it? Should I explore this with her, do you think? I said nothing at the time but I am really bothered by it.

So in the meantime I am scheduling an appointment with a devlopmental ped who speciallizes in ADHD for an eval of adhd. We can use the recent Wisc testing and they will do an eval specifically for adhd... This place is THE center for adhd in the area and my insurance will cover it. They should really know ADHD at this place and I think I would feel comfortable with whatever they find. The wait is about 5 months out, though; so, in the meantime, I want to monitor what is going on at school and get more specific information.

So what do you all think of that plan?

I think a follow-up meeting that gives you time to prepare and also allows more time for the meeting is a really good idea.


I think it's appropriate +. First, I think it sends an important signal to the school staff that you and your spouse are on the same page and are both actively concerned and involved, so it's less likely for the staff to be able to put off your concerns as due to one over-doting parent.

Second reason I like to take my dh is that although he is quiet and doesn't have the time invested in thinking through the solutions/situations/etc with our kids at school as much as I do, he is a good listener and he almost always picks up on something that I might have missed, or sees something with a slightly different perspective etc which has been really helpful.

The third reason I like to bring my husband to meetings is going to sound like I'm gender-biased and living back in the '50s... and that's *so* not me... but fwiw... the school staff does seem to take him more seriously than they do me, and I'm pretty danged sure it's all related to his gender.


That would completely annoy me too. First and foremost, if people were jumping through hoops for him, you wouldn't have to be having so many meetings at school, would you?

I would ask them to specifically explain what they mean by "jumping through hoops" - and if they explain some type of behavior on the part of teachers that's actually happening, such as differentiation... if it's really happening, thank them for that and then ask if there's a way (or suggest a way) to create a situation such that your ds doesn't have to get bored first - for instance if he's finished a math worksheet really quickly and he's bored because it was too easy, let him have some challenging work to choose next and just make that a routine part of his day, not something he has to complain to receive.

Of course, I doubt anyone is really "jumping" to actually help him, so if the staff is saying he's getting attention by saying he's bored, ask what type of attention, what are they doing that's actually any kind of perceived "reward" for saying he's bored?

Or are they saying you as his parents are jumping because he's bored? I hope not - that would be just um, completely maddening.

Sooo... now that you've asked for clarity on the "jump" thing - move right into pointing out that yes, it's perhaps not a good setup for him to be able to say he's bored and get attention for it (or whatever) BUT... it's also a sign that he needs more challenging work, so the team needs to focus on that and come up with a solution.


On the one hand I would ask her this directly, on the other hand I would consider that it's possible she's had feedback from his other teachers indicating this, or that it's possible that if he's saying he's bored often, she's heard it several times by now and is projecting forward that she'll continue to hear it.


I think this is a powerful point to use in advocating if the statement about saying he's bored and people jump comes up at your next meeting. No matter what tone it's said in, simply state again - he is bored. He is telling you he's bored. He's been telling us he's bored for three years. He's bored.


If it comes up again, you might consider letting the teacher know that the statement bothers you. It feels to me like they are putting the responsibility for the situation on your ds, when really the responsibility lies with the school staff.


This all sounds like a really good plan, Irena - including watching and observing what is going on in school while you wait for the eval.

Hang in there! And let us know if you get a meeting scheduled

polarbear

Thanks Polarbear!

I have thought more about the GT teacher's comment that "DS knows when DS says he's bored everyone jumps." And, in addition to all that you have said on the matter, the fundamental problem I realize that I have with her statement is the light in which she seems to view my son. To me this sounds like she sees him as manipulative as someone who complains that he is bored and unhappy at school just to see adults "jump" for him. First of all, he has never actually said that he is bored to her.. he has said it to me about certain subjects, in particular math. He has said he hates math class even though he loves math because it is so boring and I believe him! The work is well below him... He also has said it in the past about the books available because the books are boring, below his level and not of his interest. And I have gone to the school about these issues in an attempt to remedy them and I rarely get anywhere except for lately and still I HAD to buy books and give them to the school for him to have some books on his level.

MY son said to me a few weeks ago the following:
"Kristopher says that he loves school. I am jealous of that. Why does he love school and not find it boring like I do? Why is he having fun? What am I missing? I want to like school, I have to go there everyday... I am so jealous that everyone else seems to think it is fun and I am not enjoying it. I can't figure out what I am missing." It was really kind of sad. He's not lying when he says he is bored, he really is bored. It is not the entire problem but it is or has been part of the problem.