Gifted Issues Discussion homepage Forums Identification, Testing & Assessment "Use of SB5 in the assessment of high abilities"

You, perhaps, have more confidence in the system than I do!

I can think of several reasons why we have not gotten the assessment done. First, since I work in a medical field I have had a chance to see who is doing this kind of assessment in our town and, frankly, I am not impressed. If we did this, I guess I would like to have him seen by someone who really knew what they were doing; there are many people who don't. So we would have to travel. It costs money and would not be covered by our insurance. And, finally, I do worry about the long term effects of having such a diagnosis in a medical record.

DH has had some trouble when we tried to get private disability insurance a few years ago and part of the reason was his diagnosis of ADD. I cannot say how much better all of our lives are because of DH's diagnosis and medication. I do not regret his diagnosis, but I was surprised that it would affect his insurability.

ADD is something we are watching very very closely in DS, but I am not even close to making the evaluation step yet.

I don't mean this to suggest that someone who has a kid who suspects problems should not get an evaluation. In fact, even as I write this, I am afraid it might be discouraging to someone who might benefit. Still, I think these are things worth considering if you have a more borderline situation.

I completely agree! In fact, it is clear to us that he was a much greater disability risk before he got the diagnosis and treatment!

This is an interseting discussion of ADHD. I can't cite sources, but have read fairly broadly over the past year, and have the impression that tight focus on select subjects is consistent with HG in general. At what point does this trait become dysfunctional 'hyperfocus,' according to Sears?

Returning to the discussion of the WISC IV and SB 5 for a moment, does anyone know what the criteria are in the WISC IV to determine when alternate subtest scores are substituted for the core substests?

My DS just took this test and his scores were all over the place, from ceiling (19) on 'matrix reasoning,' to 10 (50%ile) on 'pictoral,' to 2%ile on coding. The spread was interesting in itself, but he scored 99%ile+ on both of the alternate verbal subtests ('information' and 'verbal reasoning') while scoring much lower (10 = 50%ile) on the core 'comprehension' subtest. We tested primarily for insight, so the final score is a secondary matter. But since the alternate subtests are administered, though not integrated into the index scores, I can't help wondering what their value is.

Thanks, eema.

acs-

It sounds like you and ds have found ways to manage his attention issues. So no need to pursue a formal diagnosis unless you see him struggling with life skills and schoolwork.

I suspected my son of having attention issues for a long time before we sought medical treatment. I tried behavioral consequences, charts, alternative medicine, cranial sacral therapy, dietary changes... NOTHING seemed to make a difference. He was actually diagnosed ADD through an assessment battery when he was eight, and it was not until he was ten that I gave in and called the local ADD specialist. HE had to start from scratch and do his own diagnosis, and yes, he also said DS has ADD. We hoped this guy would have ideas on coping strategies, but all he does is prescribe medication. We held off another six months and then decided to try medication. DS is on the lowest dosage which seems to affect him. I am exceptionally cautious about giving him the meds, and we tend to use them only on school days. There is a clear difference on the days he doesn't have meds- he can take hours to just shower, get dressed and eat his breakfast!

DD 8 has recently started ADD meds as well. They are really helping her with focus. Her math books used to be full of doodles and very few completed problems. I could be sitting right next to her and see her attention wandering all over the place- anyplace but on her work. When she has had her medication, she can concentrate on the things that are not her favorites.

I would not encourage anyone to put their child on meds until they have exhausted all other possibilities. If there are still glaring issues, then medication could be extremely beneficial.

I agree with you Lorel, that gifted children can indeed also have AD/HD. It is in fact VERY important to identify that both conditions exist. And VERY important to consider the giftedness when making the diagnosis of AD/HD.

Everything I have read indicates that the process of identifying AD/HD is actually a process of ruling out many other things. I have personally treated many children in OT who are placed on meds for AD/HD symptoms only to have no change or even a worsening of symptoms. Some are gifted, some are not. But often the physician's response to that medication is to stop it and try another one or up the dose to get the "desired effect." When in reality the people assessing the child have simply failed to look at all the potential reasons for the behaviors being treated. I have also, for the record, seen dramatic changes in a child when the diagnosis is correct and medication is necessary. So please don't get me wrong. I am not making a case for the absence or non-existence of AD/HD. When it exists you know it. When treatment works, you know it.

I particularly like the resource by James Webb, PhD "Misdiagnosis and Dual Diagnoses of Gifted Children and Adults" when trying to determine what is going on for a gifted child. In regards to hyperfocus, Dr. Webb states that there are no empirical data that supports the theory of hyperfocus as an aspect of AD/HD. He notes that hyperfocus is an anomaly in some people with AD/HD, not a criteria for diagnosis. Gifted people also possess this ability to focus intently on specific topics and one author this "rapt and productive attention state" as "flow." So it would make sense that gifted people with AD/HD may in fact exhibit this "hyperfocus" and still have AD/HD.

There is empirical evidence of a condition called "perseveration" and the difficulty that a child/adult with AD/HD has with changing focus between one and task and another. This would imply that staying on one task is actually easier. That would support the clinical observation of "hyperfocus" which is typically seen when children are engaged in activities such as video games, sports activities, action movies or other fast paced but singularly focused tasks. Webb notes that school actually requires the ability to shift task focus frequently and divide attention between tasks that do not have an immediate or intrinsic reward. That makes school particularly difficult for the child with AD/HD due to this inability to SHIFT focus or regulate attention.

Basically, Webb sees the description of "hyperfocus" to be a less medical sounding description of perseveration and notes that the presence of it does exclude a diagnosis of AD/HD but that it can actually be the result of perseveration and inability to shift focus. He does not, however, state that it is a hallmark of diagnosis.

The SENG website has a checklist developed by Sharon Lind called "Before Referring A Gifted Child for ADD/ADHD Evaluation." I think it is a helpful resource if you question the diagnosis or are considering an eval for your gifted child.
http://www.sengifted.org/articles_counseling/Lind_BeforeReferringAGiftedChildForADD.shtml

Oops! For some reason the EDIT function isn't working for my posts right now. But this statement should read:
"the presence of it does NOT exclude a diagnosis of AD/HD..."
Sorry.

Thanks Debbie, I had already figured it out (but only after a brief period of perseveration on the sentence!). Given that the people in my life who perseverate are very dear to me, I think that I will continue to use the word "hyperfocus" because I think, like Webb says, it sounds "less medical" and at least to my ear more respectful! "Honey, you're perseverating again," just doesn't sound like the begining of a conversation that will end well!

It was DH's inability to switch focus easily that resulted in our seeking a diagnosis. When DS was about 2, DH found he had to switch focus approximately a million times per day and it left him totally frazzled ("frazzled" being the technical term I believe).

I have to think that under the description of hyperfocus I would have to think that DD was ADHD. But I do notice behavior changes with diet. Especially in the summer when ice cream with sprinkles is more prevalent, I think she must be ADHD.

But seriously, I think you can make the description fit for a lot of gifted kids, my opinion it is part of the visual spatial world in her head. I think it is the challenge to help her with it and organize herself and learn perserverance.

My opinion, no scientific background to support it.

Ren

The Misdiagnosis book is one of my favorites.