therapist says "gifted" psychiatrist says "asperger's"

[dmarieb]

My oldest DD is only 8 1/2 and I am trying to put this out of my mind since I know there's not much to do now.  But with both potential diagnosis out there, I'm driving myself crazy!  My DD has ADHD.  I suspected when she was 2.  It took until 2nd grade for a diagnosis.  She is finally on meds and doing MUCH better.  While at her psychiatrist's office for a med check appt, he threw out aspie.  I immediately called her counselor when we got home and she said gifted.  And after reading books on both, I am stumped!  I can see her in BOTH areas.  She is definitely NOT working up to her potential at school.  She has learned to skate by.  She is reading on a 5th grade level but is in 3rd grade.  But she has been placed in the 3rd grade reading level at school.  Her school work is very inconsistent.  She understood multiplication the summer before 2nd grade.  But she'll come home with half of her simple addition problems wrong (single digits) or incomplete.  Of course, she has social issues (ADHD, gifted or aspie?).  But when I bring these up to the teacher or my friends who have kids in the class, no one seems to see the same problems.  She is very sensitive. 

Her therapist says no to neuropsych testing.  She doesn't want her under the microscope.  She also says that we wouldn't be doing anything different with an asperger's diagnosis.  Her psychiatrist says yes to testing since he thinks I'll be putting challenges on her by speculation only.  I don't think he realizes that I'm not out to teach her division, just simply keep her curious mind busy.  She was reading the Percy Jackson books this past weekend and I taught her how to do a little research project on minotaurs vs centaurs.  Just very basic but on what she's interested in. 

Does anyone have any good advice for facing all of this?  I know the info above is brief.  I didn't want to make the post too long.  Thanks!

[Stella_luna]

Why can't she be both? Many people with Aspergers are also gifted. Like my DH, for one.

And what's wrong with testing? If she is gifted, and/or has Aseperger's, she'll be entitled to an IEP if she goes to public school, which will be geared toward addressing her special needs and helping her succeed in school despite learning differences.

[Linda on the move]

Originally Posted by dmarieb 
Her therapist says no to neuropsych testing.  She doesn't want her under the microscope.  She also says that we wouldn't be doing anything different with an asperger's diagnosis.  Her psychiatrist says yes to testing since he thinks I'll be putting challenges on her by speculation only. 

My DD is both. She is gifted and she has asperger's. Her dx when she was younger was PDD-NOS and just recently changed (She's 14).

I completely disagree with your DD's therapist. Neuropsych testing is completely non-evasive. The biggest part of it is detailed IQ testing, which could really help pinpoint why certain things make sense to your DD and certain things don't. It's the pattern of highs and lows that really matter. For my *just* gifted kid, her scores are all very similar. For my 2E dd, her scores have a HUGE range. Having this information has helped the school meet her funky needs. People with asperger's tend to have a very specific pattern on the IQ testing.

The next biggest part of the the eval is tons of forms you have to fill out, just bubbles. They are scored to try to sort out what is going on. It can help sort things out and give you better information.

My next issue is with  your therapist saying "we" wouldn't be doing anything different. Who is this "we"? Is she including the school? It might make a difference in her accommodations at school. "Autism-spectrum" is actually a great label for getting special treatment in school, it's like the golden pass!

Is she including what you will eventually tell your DD? Finding out that she has the label "Asperger's" and what it means was a HUGE relief to my DD. She finally felt normal. She felt like she could quit trying to *pass.*  There are books are resources for teens with Aspergers. It's really best for my DD to have the right diagnosis and to know what it is. That's been very freeing for her. Everyone, including her, trying to pretend wasn't a long term plan.

What about down the line? Elementary was a piece of cake in so many ways for my DD. The sh*t hit the fan with puberty and middle school. I'd be working on figuring out every single thing you can about her NOW rather than later. In 3-4 years, this *may* get much more complex.

BTW, if you tell us more about her social issues and sensitivities , we can tell you our very non-professional opinions!

[eepster]

I've just got a book recommendation,  Misdiagnosis and Dual Diagnosis of Gifted Adults and Children.

[LynnS6]

Originally Posted by dmarieb 
Her therapist says no to neuropsych testing.  She doesn't want her under the microscope.  She also says that we wouldn't be doing anything different with an asperger's diagnosis.  Her psychiatrist says yes to testing since he thinks I'll be putting challenges on her by speculation only.  I don't think he realizes that I'm not out to teach her division, just simply keep her curious mind busy.  She was reading the Percy Jackson books this past weekend and I taught her how to do a little research project on minotaurs vs centaurs.  Just very basic but on what she's interested in. 

This comment by your daughter's therapist really concerns me. Who is she to be determining whether or not you get your dd evaluated?! Is she an expert in autism disorders? If she's not, how does she know that you wouldn't be doing anything difference? Having a child be evaluated is not 'putting them under a microscope', it's seeing if they need help in specific ways.

My nephew is both gifted and has AS. Understanding the Asperger's part has been crucial to getting him the help he needs both in and out of school. Before that diagnosis, all people saw were his behaviors. After that, they could put the behaviors  in context and figure out ways to help him. He's needed minimal accommodation in school up to this point, but he might need more as he gets older. Puberty is a hard time for everyone, but I think it's particularly hard on AS kids.

The average age for diagnosis of Asperger's is: 8. I can't tell if your dd has Aspergers or not, but I have a hard time seeing the harm in evaluation if you've got concerns. We had our ds evaluated when he was 8. The diagnosis was no Asperger's, but mild anxiety. That's been really helpful for me to know.

Another book for you to look at is: Quirky Kids -- I like it because it talks about when to worry and when not to worry.

And I would trust your gut with this one, not her therapist's.

[joensally]

I really empathize with what you're going through.  We were there last year.  What I reminded myself was that no matter what the correct diagnosis was, my son was the person he was and the name wouldn't change that.  It would just give us more information and additional strategies.

I would also highly recommend the books The Mislabeled Child and When the Labels Don't Fit.  I found the Oasis book on Asperger's very descriptive.

Gently said, but I'm not clear how the therapist is so strong in her assertions.  She is providing therapy to your child and advice to you.  You are the parent who is vested with the ability and responsibility to decide which routes are appropriate for your child.

[dmarieb]

I should probably state first off that I trust both the therapist and her psychiatrist.  The therapist has been working VERY closely with our family for over a year.  She has also seen my 2nd DD.  The therapist DID recommend my 2nd DD for neuropsych exam, which we went through already at our children's hospital.  She has an above average IQ and ADHD.

And the psychiatrist is the best ped psych in the area. His reputation preceeds him.  But he has only seen my daughter a max of 3 hours total.  The problem is that the psych has stated to me that a child with asperger's shows signs of giftedness but that they aren't really because their scores are inconsistent across the board.  A truly gifted child is gifted consistently.  That there are no peaks and valleys on their tests.  He said that people believe kids with asperger's to be gifted because of the peaks.  I don't know if I believe this or not.  (And I'm sure a bunch of you are waving your arms in the air madly about his comment!) 

Onto the school environment - my DD's teacher is a first year teacher.  She wants to help but the openness that I formed between us has backfired on my daughter.  (She goes to a private school).  I don't feel comfortable going to the school with this situation based on how her teacher has reacted.  The therapist agrees.  The psych doesn't agree but again, doesn't know the entire picture.  I don't have time to share all of this with him and it's not really his place in the equation to know it all.  He even started by telling me that giftedness is not his area of expertise.  (Oh yes, and her therapist does have autistic and aspie kids in her practice, as well.)  My understanding of her not wanting to test is because of the school environment not being supportive this year.  If my DD had a teacher who was in the position to help her, I believe the therapist would jump on neuropsych testing.  But because she isn't, the therapist has stated that we can do the different parts of the assessment as things come up and we want answers.  She believes that what my daughter needs most is a place for her curious mind to develop and that is what I'm doing at home.  That this year, it isn't happening in the classroom.  And honestly, if she was diagnosed this year with asperger's, I'm not sure I would tell the school.  So her therapist says that we can do it over the summer.  So now it's me sitting on the fence looking over each side wondering where my daughter's mind exists.  I'm sure there is more that I'm forgetting to type.  But that is a basic run down of the situation.

As far as my daughter - well, she has combined type ADHD.  She is extreme in her behaviors of both types of ADHD.  I've always believed her social issues to be because of this.  She's always missed social cues.  Since last year, she has been on both the ritalin and adderall family of meds.  Both caused extreme anxiety and she was put on zoloft for that.  That is when I searched out the psychiatrist since things were horrible.  She was not my daughter.  It was heartbreaking.  He switched her to intuniv and things are wonderful again.  She is her happy old self.  She is joyful and insightful.  She is curious and busy.  She loves books like Beast Quest and Percy Jackson.  But yet, she says she wants an American Girl doll for Christmas this year.  We have seen her understand social cues now since she's been on the meds.  I believe it's because the meds are finally working for her and she is able to focus and be less impulsive.  She loves to play at recess with the boys - running and playing monsters, or whatever.  She loves video games and tv.  She is a typical first child.  She wants everyone to be happy and wants to control her younger siblings.  She is unlike my 2nd DD who constantly melts down and has tantrums. 

I'm not sure if any of this helped clarify the picture at all.  I will definitely look into those book recommendations.  I have read one book on Asperger's and now on my 2nd for gifted.  None of them have been what any of you recommended.  So I will pick one of those up next!

Oh, and there is a child in her class with Asperger's.  Having spent limited time with him, I understand how the school knowing his needs has helped him.  But his situation is very different than my DD's.  Which is another reason why I'm so confused.  I know each child is a snowflake and no two look alike with the same diagnoses.  But it just confuses me that much more!  We already took an asperger's assessment test through her therapist and she only scored in the cognitive and only a few in the social.  She didn't score at all in the other subsets (developmental or sensorimotor, etc.).  Her therapist says that a small amount of kids with asperger's can score in just those areas and still have asperger's.  I should probably also mention that before I stayed at home with my kids, I was a mental health counselor, as is my Mom.  So if anyone in this picture was giving bad advice, I'd definitely know it in my gut.

[Linda on the move]

Originally Posted by dmarieb 

The problem is that the psych has stated to me that a child with asperger's shows signs of giftedness but that they aren't really because their scores are inconsistent across the board.  A truly gifted child is gifted consistently. .

most people disagree with him, but I understand your first post a lot better now. You believe, because you've been told so, that if your DD has asperger's that she's no longer gifted. Therefore, the idea of finding out if her IQ has peaks and valleys is VERY loaded.

And her therapist isn't against doing an eval, just thinks that it could wait until next summer.

I don't see anything in you latest post that jumps out as asperger's. There's nothing odd about liking Percy Jackson and American Girl. The fact that she has diverse interest would go against any ASD dx. And the fact that you don't mention sensory issues is big. And wanting every one to be happy is showing empathy.

My advice -- find out how long the wait is where you live for the eval with a really good person doing. Be sure and ask how long the report will take. In many areas, this is a year long process. There's no reason to do it now if you aren't comfortable doing it now. But if you are going to wait, it makes sense to wait with your eyes wide open. In most places, waiting until things blow up and then doing the eval means that things kinda stay blown up for about another year.

[joensally]

.I agree with Linda.

The thing with ASDs is that in many jurisdictions there is additional funding while other types of neurological differences receive no or less funding, so they're a bit du jour.  It's becoming increasingly clear that the range of neurological differences is enormous and a complicated kid isn't always on the spectrum yet is certainly out of "norm."  Mislabeled Child and Misdiagnosis/Dual Diagnosis by Webb both do a good job of explaining some of these differences. 

Actually, it's extremely common for kids to have some peaks and valleys in their tests, and often have lower processing speeds (1 or 4 areas tested by the WISC).  Kids can be gifted with learning differences, and this will often show in testing as valleys.  You may find some of the articles here of interest:

http://neurolearning.com/Library/

Agreeing with Linda that now is a good time to suss out a good assessor and figure out waitlists.  GL to you!

[LauraLoo]

Something else to consider is that by doing the testing, you will learn what you need to know about your dd - gifted / Aspie / both, / none of the above etc., rather than wondering.  One of the advantages of having thorough testing is that you can then work on appropriate strategies to help your dd compensate and thrive as necessary.  

My recommendation would be to find a neuropsych that has a lot of experience with 2E issues.  Hoagies website has some good information on what to look for and ask and also how to explain the testing to your dd.

I do hear your therapist on appropriate timing for the testing.  You will also want to ask the neuropsych how they handle sensitive & anxious children.  With my ds, who is both sensitive and has some anxiety issues, it takes him a bit of time to develop rapport with someone new; He always performs much, much better once the rapport is established.  A "getting to know you" session or two prior to actual testing may be a good idea.  

GL!

[LauraLoo]

Originally Posted by joensally 

Actually, it's extremely common for kids to have some peaks and valleys in their tests, and often have lower processing speeds (1 or 4 areas tested by the WISC).  Kids can be gifted with learning differences, and this will often show in testing as valleys.  You may find some of the articles here of interest:

http://neurolearning.com/Library/

Absolutely this.  I'm a little bit concerned that your psychiatrist has told you other wise.  Gifted people do not have to be globally gifted to be gifted, even if they are otherwise NT, with no co-morbid issues.  And the fact that your psych thinks this may also be the reason he's seeing spectrum-like issues when, in fact, there may be no issue.  There's a lot of overlap there.  Another recommendation for the "Misdiagnosis" book.

[Linda on the move]

another thought -- while nothing in your post jumps out at me as "asperger's,"  your little girl sounds very complex. The point of a full eval isn't to get a piece of paper that states what the parent already knows. It's to figure out what is going on.

It might be nice, as some point, to figure her out more thoroughly.

GOOD LUCK!!!

[KCMichigan]

Originally Posted by LauraLoo 

Originally Posted by joensally 

Actually, it's extremely common for kids to have some peaks and valleys in their tests, and often have lower processing speeds (1 or 4 areas tested by the WISC).  Kids can be gifted with learning differences, and this will often show in testing as valleys.  You may find some of the articles here of interest:

http://neurolearning.com/Library/

Absolutely this.  I'm a little bit concerned that your psychiatrist has told you other wise.  Gifted people do not have to be globally gifted to be gifted, even if they are otherwise NT, with no co-morbid issues.  And the fact that your psych thinks this may also be the reason he's seeing spectrum-like issues when, in fact, there may be no issue.  There's a lot of overlap there.  Another recommendation for the "Misdiagnosis" book.

SO TRUE! Gifted kids can have co-diagnosis ( or not).....they can have learning disabilities, they can have Aspergers, they can have ADHD, and so much more. Really, I would be concerned about the comment from your psychiatrist as well.

I have worked with kids that have a wide range of scores on testing and that has only HELPED determine how they learn best, what they know, and eligibility for Learning Disabilities/ other concerns. A 'true' gifted kid is not always across the board. A very gifted student (as per high IQ) can score low on achievement testing due to learning disabilities, that does not make that person in anyway 'less' gifted'. Some kids are globally gifted, but not all.

Behaviors (as seen in ADHD) can at times cause wild score swings too....BUT that does not rule out giftedness.

[Linda on the move]

I have worked with kids that have a wide range of scores on testing and that has only HELPED determine how they learn best, what they know, and eligibility for Learning Disabilities/ other concerns. A 'true' gifted kid is not always across the board.

I think that for some 2E kids their high IQs can help accommodate for the other challenges, and they can end up looking like a child with NEITHER a high IQ or any sn that require accommodation. (or as a kid with a lower IQ than they really have and milder sn).

Having all the info possible, on the other hand, easily leads to questions of "why is a kid with an IQ over XXX getting a D in science? How does her 504/IEP need to be different to really accommodate for her ASD?"  Rather than just telling them to try harder, focus, they aren't living up to their potential, blah blah blah.

If a child actually gets their needs met, they can really thrive. As long as they are just compensating, they really can't. If you don't even know what their needs are, then you can't even start figure out how to meet them.

I'm not sure if that made sense.

[EarthRootsStarSoul]

I really like this whole thread!  IME a person can be gifted in one or a few areas and not globally gifted.  Or another way to look at it, gifted, but with some learning disabilities or challenges in a few specific areas.  All kids are complicated and mapping out their gifts and challenges is always helpful to identify their learning style.

In second grade, my teacher accidentally discovered I had adult-level visual spacial skills, and she tried really hard to get me into the gifted program.  But they wouldn't take me because I didn't talk.  I could hear them arguing in the hallway.  Now as an adult, I've realized I am very likely on the autism spectrum and have photographic memory.  At almost 30, I'm in college for biochemistry, getting mostly As, and making good use of my gift to mentally build 3D objects (molecules). 

But in grade school through high school I really struggled with math because I was being taught wrong.  Now that I've finally learned about my own learning style, I grant myself the right to think of numbers as physical objects and shapes that can be rearranged and I am just plowing through math classes. 

[zebra15]

I just want to put this out there and please dont take offense. But I've spent my time in therapy for various reasons and DS has been seen for issues as well (both personal and gifted/developmental) and honestly I therapist could be the 'best' in a 200 mile radius but if he isn't working for my family then he is no good as far as I am concerned.  I have fired a number of mental health professionals who come highly recommended because they dont 'want' to do something for any number of reasons.  (Now I do hear them out, listen to their reasoning and do my own research as well)

I have come to realize that -I alone- am my childs advocate and I need to find the best help for the situation we are in. If that means changing providers so be it.

Now in your case I would be calling around for a second opinion. I would want my child tested to find out what is going on. Don't let the first year teacher scare you off. The school has other resources available as well. The school, or district should have a resource department consisting of a psychologist, counselor, social worker and many many aides who can also help you with your childs education.  It sounds like she isnt being challenged in the classroom and is 'bored'.

I recommend the book "Misdiagnosis and Dual Diagnosis of Gifted Adults and Children" as a good starting point.  Also go check out  www.Hoagiesgifted.org

[dmarieb]

So the one book most of you recommended is NOT available at our library!  All of the others are, however.  So I will be busy over the Thanksgiving weekend devouring books.  Thank you for all of that info!  For me, the issue isn't whether or not the counselor or the psychiatrist is giving good or bad advice.  I have seen bad counselors and psychiatrists.  I purposefully went out searching for these 2 because of the fit for our family.  But thank you for the reminder.  In fact, her counselor is VERY aware of my Momma Bear mentality.  No one crosses my child without getting through me.  In fact, her psychiatrist has put more trust in me than I am used to from a professional.  He knows I will follow my gut first before anyone else's.  I like that he knows that about me. 

The real issue is not "knowing" what makes my DD tick.  As I said before, since she has been on her new ADHD meds for a few months, my DH and I have seen amazing improvements in her social behaviors.  So maybe I need to sit back and be patient a while longer.  It's just hard waiting.  Is it Asperger's, giftedness, both, or neither!?!?!?  I definitely do not feel comfortable with the school this year.  If it was last year, I would have been much more open.  But this teacher has knocked my daughter's grades down a few notches based on her ADHD behaviors.  That infuriates me.  The last thing I want to do is bring up Asperger's to her when she doesn't understand ADHD - and doesn't care to.  My DH and I tried discussing it with her at parent-teacher conferences.  She didn't budge.  so I am not putting much stock in this year.  He and I know better, and that's what counts.  In fact, my DD stopped going to her teacher to talk and goes directly to her guidance counselor.  She is quite intuitive. :)  Anyway, thanks for all of the info!  I'll keep you posted.

[joensally]

If it's Webb, most of it is here electronically:

http://books.google.com/books?id=NQrtt-peg5AC&pg=PA66&dq=misdiagnosis+gifted&hl=en&ei=9SPsTIP0BY30tgPN04XUDw&sa=X&oi=book_result&ct=result&resnum=1&ved=0CCcQ6AEwAA#v=onepage&q&f=false

also, check out

http://www.sengifted.org/articles_index.shtml

[LauraLoo]

Another very good book and along the same lines as the "Misdiagnosed" book is "The Mislabeled Child," by the Eides.  I can't believe I didn't think of it before.  Maybe your library has this one.

http://www.amazon.com/Mislabeled-Child-Solutions-Childrens-Challenges/dp/1401308996/ref=cm_cr_pr_product_top

This book has a chapter completely dedicated to giftedness called, "The Midas Touch:  How Giftedness Can Cause Learning Challenges in Children."  Also lots of good info on autism and ADHD.  

[joensally]

Originally Posted by LauraLoo 

Another very good book and along the same lines as the "Misdiagnosed" book is "The Mislabeled Child," by the Eides.  I can't believe I didn't think of it before.  Maybe your library has this one.

http://www.amazon.com/Mislabeled-Child-Solutions-Childrens-Challenges/dp/1401308996/ref=cm_cr_pr_product_top

This book has a chapter completely dedicated to giftedness called, "The Midas Touch:  How Giftedness Can Cause Learning Challenges in Children."  Also lots of good info on autism and ADHD.  

Heh.  I recommended it upthread.  I think if either of us is posting on a thread that even smells a little 2E, the Eides will be mentioned, and if both of us are, it's guar-an-teed.  Honestly, I think they should kick us some of their royalties with all the recommendations.