Gifted Issues Discussion homepage Forums Twice Exceptional Should we seriously consider potential ADHD?

DS15, tested PG at 7, a high school freshman, has had a struggling year this year. Although he is much better managing his homework assignments, he still struggles ( getting low Bs) across most of subjects, even the ones he is good at, such as English and history. For most of math and science tests, he gets high 70s. I went to talk to his math teacher and looked at his exam paper and found 80% of errors are due to careless mistakes ( missing negative signs, copying numbers wrong, reading problems incorrectly). But it is something he can not seem to overcome. Instead of trying to figure out a strategy to improve, He avoids the issue and developed a sense of " I am not good at math". He can not get himself to study or even work on his homework problems despite knowing at he is on verge of slipping to a C if he does not do well enough in next quiz.
he has had trouble with math since 7th grade, basically never learned how to study math or other subjects he is less interested in.

meanwhile, he has become a very capable debater, winning top awards at state and regional level as a freshman. With no coach, he and his club members work on their own to learn, design strategies, learn from mistakes and constantly improve. He can concentrate for a long period of time when working on debate research or practice. He also excels at writing and mock trial and has had a very successful year. he also participates actively in school clubs and activities and does not seem to have a social issue.


We are at wits end to figure out what is the underlying issue with his academics. We could let him take lower level classes next year (which he absolutely hates the idea) but I think this does not fix his real issue. We start to really suspect he has an undiagnosed ADHD that is preventing him to focus on less interesting subjects. By the way, he regularly falls asleep in Spanish class and his excuse was that there was a period of instruction so boring and he could not help falling asleep. Starting a couple weeks ago, he started to get up really early in the morning around 5:30 to "work on stuff", which I think 80% is non school related. I don't really know what he works on in the morning other than what he told me. What I do know is he is not very interested video game, but more interested social network and chatting online. I understand he needs privacy and not to be bothered but why would he need to get up so early in the morning. He does go to bed before 10:30 at night.

I know its hard to tell but should be get him to see a psychologist for ADHD or other issues? His IQ score from age 7 was 147 full scale with only low score in processing speed of 109. there wasn't any mentioning of issues in the report. His underachieving behavior and anger issue started in 4th grade. At 15, he gotten much better at controlling his emotions with almost no anger outbursts, instead he just stays in his room more than ever.

Thanks for reading...

Yes, some pretty classic patterns here - I would definitely agree that assessment would be helpful. Something beyond his control is getting in the way, and it's having negative impact on how he sees himself, as well as his school work.

It could be ADHD and/or some other kind of learning issue that's affecting information retrieval, reading or writing. If you know what's getting in the way, he can start figuring out what he needs to do differently in order to be able to do well. I would be prepared to find he's got a lot of anxiety, and a lot of resistance to change, if he's ingrained the idea that "I am not good at this". For us, digging the poor kid out of the deep anxiety hole they're in is always the hardest part.

Also worth noting: 2E kids can be really good at compensating and hiding their issues, so you may have to do some serious searching to find a psych that knows how to look for these challenges in a PG child.

Thanks Platypus. yes I am seeing a lot of resistance to change and avoidance and frustration.

Purpleviolin

This sounds a great deal like my DS14 who is finishing up his freshman year in high school. He tested not quite at your DS's FSIQ level at age 8 but close (144). In late middle school, he started to kind of lose it in Algebra and could not keep himself organized and was struggling in nonstructured environments. Luckily we had a full work up the summer before high school and figured out he had ADHD-Inattentive and Dysgraphia. He's on low level meds now and is excelling in all his classes including 4 Honors classes with tons of work.
Of course, ADHD is often co-morbid with another condition and his tendency toward anxiety emerged but I am hesitant to put him on meds for that with summer break coming soon and we provide a great deal of support at home. In any event, yes you should definitely have a full work up for your son. In addition, at age 15, I would be concerned about all the time spent "working on stuff". It could be innocuous but it's a much different world out there than when I was in high school.
Good luck and keep us posted!

OCJD, I actually read you posts and I am happy for your family that your son is having a great year and is thriving. I found the situation you described earlier this year is exactly like what my son is going through, except that my son also resists help and change. He is in a lot of denial.

I am going to get him tested at Summit center this summer and go from there.

Did the meds work right away for your son? do you see any side effect?

Hello,
Glad to be of some help. My DS was not necessarily willing to accept help. He was really resistant to meds (as I was, it's a very difficult choice to make). Interestingly, now that he is on meds and is doing well, he is more accepting of help such as allowing DH and I to help him prep for tests, quizzing him, helping him edit papers, and sitting down with us to help him plan out his weeks as far as work, tests, etc. He really sees the benefits in lists and plans for tackling large projects. He has remarked that he no longer feels overwhelmed with work.

I would say yes that we saw results immediately because he had an online class to get through last summer before starting high school. His first few attempts at the extremely easy work prior to meds was like pulling teeth. He would hardly write anything and had little depth of analysis. After getting started on meds and getting used to being on them, he flew the rest of the course with no problem and with more efficient use of his time.

Side effects. Yes. I did not fully understand how parents and health care professionals must weigh the benefits vs. the side effects until this experience. He is very tall and skinny (6ft 1 and 117 lbs) and these stimulant meds kill his appetite so I have to try cram food in him at breakfast and in the evening when he wants to eat again.
The most recent side effect is tics. From all I've read, stimulant meds do not cause tics but if you had a predisposition to them before, it may bring them out again. He had a short episode of tics a couple of years ago during a high stress time at school. Earlier this year during a stressful time, he started going through a sequence of head rolling, then went to nose twitching, then mouth moving. We saw the neuro who said well, you could go to non-stimulant meds but they simply do not work as well for focus as stimulant meds. He could take a separate med for the tics but, while thinking about this, in the meantime, they kind of calmed down or maybe we all got used to it. I don't know. He claimed not to be bothered by them really. Our plan is, once school is over for the year, to give him a med break and see if they go away and, if they don't, see if we can get some efficacy from a non-stimulant medication. He likes being on the meds because he feels like he is achieving what he is capable of in school.
I think, as a parent, one weighs that against the side effects. He feels confident in his future and while, he would like his tics to go away, he does seem willing to put up with them. (Me Shrugging).

Sorry for the book. So meds are not panacea nor would I want him to be on them forever but that's really out of my hands. If your MD/Psych recommends them after a full work up, think hard. Ask him/her all kinds of questions. DS is making some strides socially but he is still immature, which is not good in HS. He's very young for his grade (his date for winter formal was a whole year older than him and she looked it!) so his PFC deficiencies are exacerbated. But his prior problems with personal space or focus in social conversations have gone so there is hope in that regard.

Again, I'm sorry for the probable overabundance of information. Happy to answer any further questions.

Best regards.

Thanks so much OCJD,

I can relate with things you described here, such as the summer online class, which was a bridge class offered by school district. It was such a struggle to get him to follow the schedule, watch the instruction videos, or doing the assignments. He would resist or completely forget about it and made up various excuses when we asked him about it. This kind of struggles have been going on since 7th grade and caused many tensions in the family (lies, anger outbursts, withdrawal and etc.). But we never really thought about ADHD or any other learning disabilities because he is not hyperactive at all and he could focus very well on interesting subjects. All I have been seeing is executive functioning weakness.

Focus on interesting subjects is not difficult for many ADHD kids. It's the power to focus on the uninteresting things that is where the rubber meets the road. They can hyperfocus on the cool things they like. My DS loves cars and will spend hours reviewing specs, articles, test drives, etc. Social media is a significant trigger for many kids (as it is for adults) and they cannot turn it off often times.

My DS is not hyperactive either.

The lies I can relate to as well since the judgment can be affected. When they are asked, "Did you do XYZ?", they easiest answer is "Yes" even if they have not. It's the path of least resistance. Anywhere from brushing teeth to doing homework.
It was a real problem in the family for a while because it did not make sense. "How could you forget to X, we just told you 15 times?" My DH had real issues with him for a while because he is the polar opposite. Plus my DD11 who is in 6th grade is also the polar opposite, stellar student, followed all directions, organized, and an outstanding athlete. She is gifted as well but not to the level of DS likely.

Sports were a problem for DS because he could not follow the directions and lacked the processing speed to understand the most basic of plays in any team sport. It all makes sense now when I look back on it. Sports were not interesting for him, hence, no focus. Poor kid, it was hard in our sports-obsessed area where we live.

If you have not, I urge you to visit the CHADD.org website. It is very helpful.

What you have described is a lot like my family, especially about how polar opposite DH is from my DS15 and for a couple of years they struggled to get along with each other and for DH to accept who he is. My younger son is HG and also 6th grader. He has inattentive traits (also not diagnosed)and auditory processing issue, but he is very calm and has a positive attitude toward learning in general. We saw him improving significantly is doing great at school this year, learning to organize, following through instructions and even self advocating.

DS15 is also not athletic, but the worst part was his lack of efforts for almost all the sports he has tried since kindergarten. This drove my husband crazy and what DH sees in him is attitude issue and uncoachable. What you said makes a lot of sense "Sports were not interesting for him, hence, no focus". I think school work is also extremely boring to him, so no focus either. It's hard to watch.

I will check out CHADD. Also, we live in southern California, if you happen to live in OC (as in your username), can you recommend the pediatric psych for your DS? Feel free to pm me.

Thanks so much!

Major yes to everything OCJD said.

With respect to meds, DS15 started on them about a year ago. No miracle cures in our case, unfortunately, but they do seem to help (and we are still playing with type and dose to see if we can do better, as is unfortunately often the case with these). He's still got a whack of complex LD and zero executive function, but I think the meds are at least helping him be more able to learn how to cope with those weaknesses. While school is rough, there are definitely things he can do now that he absolutely couldn't a year ago.

As far as side effects, we've been lucky. He has always been bad at eating and sleeping (thus my reluctance to try the meds), but has been ok after a short transition each time we muck with the dose. He's actually sleeping better in the last few months than he has in years, as it turns out.

Avoidance is our bane (I've vented a *lot* about it here). It's a really tough habit to break, because it gives him a sense of safety. But you know, as I write this I am thinking "wait a sec, is this one of those intangibles that has changed over the last year?" I need to give this some thought, because I think maybe it actually has. Now that would be an effect of meds worth celebrating. I will ponder over (much more) coffee whether I can better identify/ articulate any change.

And I doubt it's any any consolation, but in our case DS and DH are extremely alike, and that seriously didn't help either.

Another good resource is https://www.ADDitudemag.com . They have a lot of info about the inattentive form of ADHD, which tends to get short shrift in most resources. I didn't even know there was such a thing until I started researching my kids.

Lots of hugs and good luck!