Gifted Issues Discussion homepage Forums General Discussion Gifted 9 year old girls struggles

My daughter's teacher two years ago noticed my daughter didn't comprehend as well as she could read. Would only give one sentence answer etc. also noticed she wasn't great at following multiple steps directions and would have to ask the teacher what she was to be doing. We decided to have an psycho educational assessment on her. She didn't qualify for an ADHD diagnosis, but they found out her IQ is 130.
These issues are still apparent now two years later, so I decided to get a second ADHD opinion. She still doesn't quality. Mostly because we don't notice symptoms at home and they say she isn't significantly impaired.
I am at a loss of what to do. Anyone else's gifted childs teacher think they had ADHD but they don't?

Welcome, wmom!

Sometimes ADHD (especially primarily inattentive) is more subtle in higher cognitive kiddos, because they're a lot better at masking, or at using compensatory strategies to power their way through some of the tests used. But it's also possible that something else is in play. We don't have much to work with in terms of data at this moment, but what you describe could also result from an auditory processing disorder, especially with difficulty following multistep directions and comprehending oral language. One-sentence answers also raise questions regarding expressive language delays. It can be hard to tease out all the possible factors, especially depending on the nature of the evaluation data you obtained.

There are also other executive dysfunctions that don't meet ADHD diagnostic criteria. But just because they don't meet criteria doesn't mean they don't affect one. If you feel comfortable posting, what instruments did they use? (If not publicly, you can pm me; just let me know you did so, or ask me to pm you, as my inbox is kind of full!)

Why did they not diagnose your daughter? Did something else explain the symptoms or not? It may also be because of learning disabilities or expressive language delays.

How did they observe your daughter?

You can PM me about the processes and instruments and I can give you my viewpoint.

But sometimes ADHD in gifted can be underdiagnosed due to compensation and milder presentation.

They used the wisc 5 or something like that. All of her categories ranged from 96 to 98 percentile. Her profile wasn't spikey. (Not.sure if that matters)
She doesn't have an expressive language delay. She is capable of giving more answers, but just doesn't. Or says she doesn't remember.
We really don't have many issues at home. I think that is why they are hesitant to diagnose. They said she has to have significant impairment in two settings.
She can focus at home. But she can be forgetful sometimes. Deep down, I feel she has it. But I read online that gifted children can appear inattentive at school if they're bored.

It sometimes matters, as some issues with a certain test may indicate potential further issues to explore. She does not need to have significant impairment in multiple settings as that was a DSM-IV requirement. The DSM-V and TR version simply states there is "clear evidence" of impairment or interference, and the impairment does not need to be significant.

To be clear, are you referring to issues as in impairment or issues as in symptoms?

Developmentally gifted kids may be ahead so they should be assessed against developmental age, not chronological age.

However there are many other issues that could cause forgetfulness so be sure to go to physical doctors too and other professionals as necessary.

It's tough navigating the intersection of giftedness and potential ADHD concerns. Your experience echoes a common struggle - high IQ but challenges in certain areas. Have you explored alternative support strategies tailored to her unique strengths? Maybe engaging activities like run 3

FWIW, if the WISC-5 was the only measure given, that's not really sufficient to rule ADHD in or out. School-based psychoed's can be very useful (but that is what I do, so I might be biased!), but schools may not have all of the resources necessary to sift through the subtleties of a twice exceptional learner. And on the other side, pediatrician-based evals for ADHD tend to be rather cursory (I also tend to be the pass-through for the teacher information that they request, so I see that data). To be clear, I am not taking a side on whether she has or does not have ADHD. Just saying that if there are functional concerns (including how she perceives herself as a learner), then it may be worth investigating further with someone who has both the skills and experience relevant to a 2e evaluation (such as clinical/neuro/school psychologist with specific 23 experience). If there are not functional concerns, then I would probably go with watchful waiting, if it were my child.

You note that she may also be bored. It's worth thinking about why you do not see the symptoms at home, but the teacher reports them in school. How are the settings different? --in structure, --in demands, --in stimulation, etc. Because it's possible that she really does not have ADHD, and the problem is not located within-child, but within-environment (the school environment). A learner significantly underplaced with regard to their actual intellectual stimulation (aka learning) needs can appear much like a learner with ADHD, even to the extent of underperforming on easy tasks. Just think about how well any of us would do on staying focused, following directions, and completing tasks with accuracy if our instructional environment as reasonably competent adults was at a kindergarten level.

And on the other hand, you may find that the home environment is subtly scaffolding executive functions (attention, organization, etc.) in ways that the teacher either cannot or does not.