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ADD assessment

post #1 of 12
Thread Starter 
Is anyone aware of a way to assess a child for inattentive type ADHD that doesn't rely solely on behavioral scales?

Dh was dx as an adult with ADD but has never been treated and is generally an unhappy person who thinks that he is stupid. Dd10 exhibits many of the same signs and I am really worried about her.

She has wildly erratic grades and test scores. For instance, the MAPS (achievement) test that the school gives put her in the 58th percentile for reading in May of 2010 and the 94th for reading in August 2010. Math MAPS do the same thing as do her other standardized tests. Her "strengths" and "weaknesses" on these tests also change everytime she takes them.

She may get an A on a practice test on Monday and then a C on the real test on Tuesday and then an F when she is allowed to retake the test. She loses her place on the page when reading constantly and stops mid-sentence b/c something came to mind or the sentence didn't make sense without the last few words and she is confused. Once I prompt her to read the whole thing, it is always "oh! that makes sense."

On individual achievement tests, her reading consistently tests btwn the 95th-98th percentile with her speed dragging the score down (it tends to run the the bottom 25% with everything else very high). Likewise on individual achievement tests, math runs around the 98th-99th percentile and writing consistently at the 99th. The group NCLB tests run in the "proficient" range.

She's been IQ tested twice (once to rule out LDs along with the individual achievement tests). The scores were 20 pts apart over the course of one year with the first testing being higher (99.9th percentile vs. 97th the second). Either way, she seems to be able enough that she shouldn't be struggling so much. Her school has given me the "good guessing" line too many times to count regarding her IQ scores and higher achievement scores.

At this point, I'm not hearing that exact line, but they prefer to place her in the lower groupings where she can get As vs. the advanced classes where she is so erratic. I'd be okay with that if dd was okay with that, but she isn't. She's very competitive and feels really bad about herself when she isn't placed in a class where she has to do something. Her spending the class period daydreaming is also worse in the easier classes, but the work is so easy that she can still get by with good grades. She also tends not to have friends when she is grouped with kids who are struggling students. There seems to be a lack of rapport with the other kids when she's in that spot.

I'm basically hearing lack of ability or lack of effort from her school as to her erraticness. I really don't think that either is the case.

About a year and a half ago, we had the psych who did the last bit of testing look at ADD as well. She did this solely based upon a behavioral rating filled out by her teacher, me, and dh. I believe it was called the BASQ. This didn't work out too well b/c dh, while meaning well, tends to see the worst case scenario and filled the thing out such that it looked like she had everything from schizophrenia to bi-polar. The teachers don't see a problem b/c, at her worst, she is at least at grade level and she doesn't cause problems in school. She sits quietly in the back of a class of 30+ kids and daydreams. Her teacher put everything in the typical range and wrote that dd was "nothing special" on the form.

With the teacher thinking that there was no problem and dh's form virtually unusable, dd apparently didn't have ADD. Is there anyway to rule in or rule out ADD without relying on the subjective opinions of teachers and dh?
post #2 of 12
If the school (including school councilor) isn't being too helpful go straight to your doctor. Your dd sounds like she does have ADD inatentiveness. Exactly the same as my son.
post #3 of 12
Thread Starter 
We are going to do this privately. Our insurance is having us go directly to a child psychologist. Since I work at the hospital at which the psych is affiliated, I know her. She's out of town, so I'm expecting to hear back from her early next week.

What I am wanting to know is whether there is anything I can ask her to do other than look at behavior rating scales?
post #4 of 12
I was diagnosed as an adult. In addition to all of the behavioral scales, there was also a computerized assessment that was part of the battery of assessments. If you send me a PM, I'll send you a link to it. My former neuro-psychiatrist has it on his website.
post #5 of 12
Quote:
Originally Posted by ChristaN View Post
We are going to do this privately. Our insurance is having us go directly to a child psychologist. Since I work at the hospital at which the psych is affiliated, I know her. She's out of town, so I'm expecting to hear back from her early next week.

What I am wanting to know is whether there is anything I can ask her to do other than look at behavior rating scales?
I don't see why your dh's form has to affect anything. You seem to have enough information to give them.

Don't let the school act as if there is not a problem; as you said (and I have experienced) if they are on grade level and are not a behavior problem, that is what matters most to the school. Often they are not interested in what your child can achieve with the right support.

A diagnosis will make it easier to get a 504 plan, including things such as the teacher giving her periodic reminders to stay on task, or certain testing conditions.

ADD can be medicated as well; medication may improve her ability to focus on a task.

ADD Medication...
post #6 of 12
DS' psych used a TOVA test as part of his adhd diagnosis. Google it, it is objective.
post #7 of 12
Thread Starter 
Thanks, everyone. If you actually got through my long first post, does this sound like ADD to you?
post #8 of 12
Not an expert by any means, although both of my kids clearly have attentional issues.

My understanding is that ADD/ADHD can be seen on a certain type of brain scan (can't locate my notes I took when speaking with a psychologist), and that it can be suspected from certain psychometric testing scatters (I've been told this by professionals, but can't find any online references just now, so take it for third-hand maybe ). I'm also very resistant to subjective inventory tools and wish there was something more objective.

I found this, though I don't know if it means anything.
http://www.adhdtesting.org/tova.htm

Have you dug around on the Eides' sites?
http://neurolearning.com/Library/attention
http://eideneurolearningblog.blogspot.com/

Do you have access to academic articles? There are some bits and pieces about gifted and ADHD etc diagnosis that are interesting.

Have you read much about executive function? ADD/HD is an EF deficit so there may be more info that way.

DS meets the criteria for ADHD based on the Connor's inventory at school, and a bit in community - but he has SPD, has vision issues and is gifted with lots of OEs. ADD/HD is supposed to only be diagnosed after other diagnoses have been ruled out. I'm choosing to not worry about a diagnosis but rather to try to build his attentional skills through various strategies. DD also has some focus/attention issues and we're finding she's more organized and focused at 11, and that's due to both age and a really connected, resourceful teacher last year IMO.

I've been reading various books on ADHD and have found various nuggets that help, and I may buy a couple of the ADHD books available at Prufrock Press as they look interesting in the pdf previews and they're currently 20% off and free shipping.
http://www.prufrock.com/searchproducts.cfm

With your DD, something is clearly going on given the sporadic performance. It's too bad that the school has such a non-strength based approach.

Sorry post is so choppy - supervising DS's playdate with another 8 year old boy who has textbook ADHD, so you can imagine what my house is like just now .
post #9 of 12
Thread Starter 
Thanks. I hadn't yet looked at the Eides' site, but I will. Dd12 has sensory issues. I'm pretty sure that isn't what's going on with dd10. She seems more internally distracted (by things going on in her head) and seriously lacking in attention to detail (might completely forget to do one whole page on a test b/c she didn't notice it was there). My older dd with the sensory issues performs markedly better when the environment in changed. Dd10 does not.

It's good to be able to research this a bit more before I speak with the psych next week, though! In terms of IQ scatter, dd consistently tests in the 99th-99.9th on the two parts of the verbal piece that don't deal with social comprehension and logic. The "comprehension" piece is the one that twice had pulled her VCI "down" to the 99th and 99.7th, respectively. She scored in the 75th percentile on the comprehension piece last time. She is consistently much higher on verbal and perceptual parts than working memory and processing speed, which are both average.

She does also seem to have some seriously out of the box thinking or logic issues. One of the examples her math teacher gave me was dd missing a bunch of word questions that asked things like, "what is the lowest altitude?" There was a table with highest altitudes for various states and lowest altitudes for the same states in two columns. Dd answered not with the lowest altitude overall but with the lowest of the highest altitudes. She does stuff like that all the time. I imagine that her creativity could benefit her in some areas, but not on standardized tests.
post #10 of 12
Quote:
Originally Posted by ChristaN View Post
Thanks. I hadn't yet looked at the Eides' site, but I will. Dd12 has sensory issues. I'm pretty sure that isn't what's going on with dd10. She seems more internally distracted (by things going on in her head) and seriously lacking in attention to detail (might completely forget to do one whole page on a test b/c she didn't notice it was there). My older dd with the sensory issues performs markedly better when the environment in changed. Dd10 does not.

It's good to be able to research this a bit more before I speak with the psych next week, though! In terms of IQ scatter, dd consistently tests in the 99th-99.9th on the two parts of the verbal piece that don't deal with social comprehension and logic. The "comprehension" piece is the one that twice had pulled her VCI "down" to the 99th and 99.7th, respectively. She scored in the 75th percentile on the comprehension piece last time. She is consistently much higher on verbal and perceptual parts than working memory and processing speed, which are both average.

She does also seem to have some seriously out of the box thinking or logic issues. One of the examples her math teacher gave me was dd missing a bunch of word questions that asked things like, "what is the lowest altitude?" There was a table with highest altitudes for various states and lowest altitudes for the same states in two columns. Dd answered not with the lowest altitude overall but with the lowest of the highest altitudes. She does stuff like that all the time. I imagine that her creativity could benefit her in some areas, but not on standardized tests.
Have you had her vision checked by a developmental optometrist? DS has vision issues and he sometimes seems a bit random at times, I think because he's seeing the sheet differently. He has great compensatory skills for some things, and none for others.

It's extremely common for gifted kids to have lower processing and working memory speeds. DS has ceilings except in processing and WM. There's a fair bit written about it. Have you read Silverman on WISC, or NAGC's position statement? And are you familiar with GAI? If the processing and WM scores are dragging the FSIQ down due to statistically significant SD differences, the GAI is recommended by the test makers and NAGC.

I'm really glad that you're seeing another psych, and hope that she'll be able to advocate for your DD. It's ridiculous that the school is taking the attitude they are.

I find the Eides sites a goldmine of information. They have a passion for kids who see and process the world differently, well beyond spd. DS has a whole bunch of stuff going on, and the issues cross-influence each other so it's hard to figure out what's at play at any given time.
post #11 of 12
Thread Starter 
I am familiar with the research re lower WMI and PSI in gifted kids. Dd12 also had much lower processing speed when tested at 7.5, but her memory is also extremely good (and tests well). I'm also familiar with the GAI. Dd10's IQ scores were GAIs. Her FSIQ was in the 98th the first time due to those lower WMI and PSI indeces vs. 99.9 for the GAI.

She has had her eyes checked twice -- once by a developmental optometrist and once by an regular one. Despite being very slighly more far sighted than typical, there isn't anything seriously wrong there.

I've kind of ruled out most other possibilities that come to mind except possibly dyslexia.
post #12 of 12
Quote:
Originally Posted by ChristaN View Post
I am familiar with the research re lower WMI and PSI in gifted kids. Dd12 also had much lower processing speed when tested at 7.5, but her memory is also extremely good (and tests well). I'm also familiar with the GAI. Dd10's IQ scores were GAIs. Her FSIQ was in the 98th the first time due to those lower WMI and PSI indeces vs. 99.9 for the GAI.

She has had her eyes checked twice -- once by a developmental optometrist and once by an regular one. Despite being very slighly more far sighted than typical, there isn't anything seriously wrong there.

I've kind of ruled out most other possibilities that come to mind except possibly dyslexia.
Have you seen the Eide's slide on dyslexia, or their dyslexia site? I'll go find the powerpoint and come back and post it.

Signed,
Eides Fan Girl


ETA:
http://www.dyslexicadvantage.com/cat...tml?download=4

See the 27th slide and further for other detailed info.
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