Giftedness, ADHD or both?

[Triniity]

Hi, 

this might get a bit complicated. I am a bit lost here. I naturally wrote a lot about my kids here. However, I did not find a real solution yet. 

They have been tested for ADHD and both been diagnosed. The IQ Tests showed that both are gifted as well, Ds is still quite young for such a "diagnosis" I believe, and in DD they found a learning disability as well, which makes it difficult for her to do these kind of tests, so she apparently even more gifted because the IQ is false low. 

I read about giftedness and not getting enough input and therefor acting as if ADHD. Would the tests still show the ADHD than? Or is this a proper diagnosis. I am so unsure. And how do I work with it now? DD is able to concentrate very well if interested, but if it a little bit boring she just.does.not.concentrate. And the beginnings are not really exciting, mostly. Like learning how to play an instrument or like learning a language. It is fun as soon as you actually realize you learn something, 

How do I keep them happy and engaged? 

Anybody here with the same kinds of problems?

[Geofizz]

(My experience here is from the school psych suggesting ADHD for my DD, and neuropsych testing suggesting that she does not have ADHD)

Your kids are really young. Really young. Younger than most psychologists would be willing to diagnose ADHD, particularly in a boarderline or more complicated piece.

What testing went into the diagnosis?  What's the learning disability?  How severe?

Proper testing with a tester experienced with kids that age should be able to distinguish "bored" from ADHD pretty easily. 

HOWEVER, processing speed and working memory significantly below verbal and perceptual skills (assuming WISC/WISPII here) are generally taken to be an indicator of ADHD.  However, many gifted kids are verbally gifted and gifted in perceptual/spatial skills without the Ferrari engine (high WM/PSI) driving all of it.  So it can lead to some confusion in the diagnosis if the diagnostician isn't experienced with gifted kids. This becomes a bigger problem with the more gifted the child is. You can calculate the general abilities index (GAI) from the WISC subtests and compare it to the FSIQ to get a sense of how big of an issue it is. In my DD's case, the difference was "just" 15 points, and this was considered a factor of how gifted she is, not that the WM/PSI were deficient.

Observation during testing can be revealing, as can the parent/teacher/coach surveys, and other testing  (DD took the IVA -- this is torture and should be banned by the Geneva Convention -- and the NEPSY) can also inform the diagnosis.

Throwing a learning disability into the mix complicates things. ADHD is a diagnosis of exclusion:  You can only count behaviors not otherwise explained by the learning disabilities or an inappropriate learning environment.  As an extreme example, my DD's behaviors in math were attributed by the school psych as ADHD.  We decided later (with the neuropsych report in hand, and a vice principal fully brought into the loop) that the problem was that DD's math environment was not conducive to either concentration or engagement.  Solving the noise distraction issue and solving the lack of instruction issue eliminated the ADHD-like behaviors.

If you are skeptical of the diagnoses, then address the behaviors and learning challenges as they come up, continue to watch and observe, and return to it in a few years when you have more information and the kids have grown up some. 

When it comes to keeping the kids happy and engaged, this is the $64k question, right?  And it's the right place to focus your attention IMNSHO.  First things first:  Is your DD's learning disability being addressed effectively?  That should be first on the agenda, as this can throw up blockades in all aspects of life.  If she's in school, then you should approach the school with the testing results, be upfront about your skepticism on the ADHD diagnosis, and ask for their teamwork in addressing your daughters talents alongside her deficits. 

Good luck.  You are addressing these things really early.  You are lucky and smart to have caught learning disabilities in such a young child.  Early remediation is key.

[Geofizz]

FWIW, all my comments pretty much address your 6 year old and assuming your signature is up to date. I wouldn't trust the testing in a 4 year old unless the issues are really severe. Why did you have him tested?

[dkorovikov]

[deleted]

Edited by dkorovikov - 11/12/12 at 2:58pm

[Triniity]

Thank you for your reply. All these abbrevations of tests....I totally cannot understand them...obviously I don't know enough about testing

They did some kind of IQ testing plus a couple of other tests. they established a problem with her visual integration, which will  make reading and writing more difficult for her. We already started OT, and I talked with the teacher who will look after the first grade this year. She'll have a look at her and than we'll meet after 1 -2 weeks. This result was kind of by chance, I had no clue. I was wondering, however, that she was not reading, since she knows the letters and can form words if the words are on one page, like with really large letters and far apart, but not in normal books. That puzzled me for a couple of month already, since she is so interested in books and writing and everything.

The four year old is very difficult to handle at times, and he has sensory integration disorder,  but he was kind of tested because his sister was. Honestly, the reason to test them was more to say: See, no ADHD and now leave me alone - the preschool teachers asked for it.

But it caught DD's problems, this is a good thing

[Geofizz]

Have you seen a developmental opthamologist?  Yeah, subtle vision issues can have huge effects, but I'd want it diagnosed by an expert.  There's a lot of debate around the scientific grounding in vision therapy, so go into any therapy with your eyes open.

Do you have options in preschools?  I'm wondering if you could seek out a better fit between teacher and child. 

Sorry about the acronyms.  Google is your friend.  I'm happy to define anything if you need it.  Mostly I was talking about the different components of the Wenchler IQ tests.

dkorovikov, the differential diagnosis is part of the DSM.  The issue of whether or not a school will serve a disability according to the differential varies by state, district, principal, distance to the nearest lawyer, and phase of the moon.  I disagree with your assessment that a child with a 98%ile IQ shouldn't be performing above the 50th percentile if taught with the class.  Even with no differentiation, a child understanding and following lessons better than their peers should have better outcomes.  They may not reach the 98th percentile, but they should be above the average.  Otherwise, there would be no difference in performance amongst children.  There is, and there's a significant bell curve to performance, and these have been normed to large populations.   Even feeble differentiation in reading, however, should produce reading scores within a standard deviation of the VCI as these kids have greater verbal ability to take advantage of the instruction. 

As an admittedly extreme case, in math (for my son -- no LDs and PG in math, tested before any math instruction in school), you can see the stark difference in ability and instruction between the math concepts and applications vs the computation scores.  Even here, the tester's notes indicate that he was using his conceptual understanding to work out calculations of math he'd never seen before, still placing his computation scores in the EG range.  She actually noted that she thought the score was an underestimate because he didn't know how to write the numbers yet, so he didn't use scratch paper to do his calculations -- everything was in his head.  Here, a tester with some experience helped interpret the situation.

[dkorovikov]

[deleted]

Edited by dkorovikov - 11/12/12 at 2:59pm

[staceychev]

Just want to chime in to make sure that the person making the diagnosis of your daughter has worked with gifted children. The DSM, which is the book that lists all of the psychiatric disorders, was revised earlier this year (or late last) and the "net," so to speak, that catches ADHD was cast wider to catch more kids. The problem with this, at least as far as advocates of the gifted are concerned, is that a lot of kids would fall within diagnostic criteria because of the characteristics of giftedness itself. SENG posted a good video talking about this here. 

SENG also has a checklist comparing gifted behaviors with ADHD behaviors here. 

I'd also be really wary of a diagnosis of ADHD with a four year old. Teachers like compliant children. 

I'm not saying that the diagnosis is incorrect. I'd just be a little wary. 

Good luck!

[meemee]

i am in the same boat as you. but with an almost 10 year old. only because i am noticing it more now. earlier i passed it off as a child thing.

i am going to do a caffeiene test and see if that changes anything with dd. does that help her focus. 

dd is the 'quiet ADD' gal. absolute impeccable behaviour at school, but lives in her head and wanders off when she doesnt like something. 

i think dd is on the cusp where seh could go either way. 

[Triniity]

Funny thing is, I am gifted - or was gifted - I feel so not gifted anymore - I live in foggy-land . Plus, I have an appointment in september for an ADHD diagnosis. In this clinic they do all the questionaires beforehand, and if the results look like ADHD they give you an appointment. I got one. DH is diagnosed with ADHD - he is probably gifted as well - he lives in lala land though - inattentive ADD.

I got coffee every morning since I was five, because I had a severe autoimmune disease and the medicines made my really hypotonic. My ped prescribed one coffee in the morning. I am wondering if I was able to function because of this coffee ... I was a wild child though. Not physically, because of the autoimmune disease, but with my mind.

What do I do with them now? I am at loss. should I teach them - offer them input - if so, how?

[Triniity]

thanks for the links stacey! I can cross off every point on the "giftedness" side. - that would mean she is underchallenged - which is not much of an surprise anyway.

Do you have solutions to the problem though?

for example how do I teach social behaviour as in: people need their own space, you can not come so close to stranger, they might not feel comfortable with it.

If you want to say something you need to wait your turn and not start screaming in this high pitched voice until everyone listens to you (this is more DS)

[Geofizz]

Originally Posted by Triniity 


for example how do I teach social behaviour as in: people need their own space, you can not come so close to stranger, they might not feel comfortable with it.
If you want to say something you need to wait your turn and not start screaming in this high pitched voice until everyone listens to you (this is more DS)

A good starting point might be the book Smart but Scattered. Your 6 year old might be on the young side for the specifics, but the book might give you a useful framework from which to start. The chapters on emotional control were very eye opening for me.

The book is written for parents of kids whose executive funtion isn't matching their other performance in life,but aren't so severely impaired so as to fit an ADHD diagnosis.

[BrainParenting]

Hi there:

Getting too close to people indicates that her proprioceptive sense isn't fully developed.  Proprioception is a sense that children grow, that tells their brain where their body is in space.  One interesting test of this is to have your daughter close her eyes.  Touch a part of her upper arm and ask her to touch the exact same place on her other arm.  Even after a lot of therapy, my son was a good two inches off. And he would walk right into other people.

Problems with voice modulation could have to do with her auditory processing, and again, you can do some exercises for that.

We are putting together a parent-run website that will source the best places to get this type of information (it's currently in construction) but we put links onto our Facebook page: www.Facebook.com/BrainParenting

One of my favorite overviews for the whole OT thing is this one. This lady gives you a great overview AND some free exercises:

http://www.ot-mom-learning-activities.com/

If your daughter has trouble with vision tracking, that's a serious thing and yes, you should go to an opthalmologist but make sure that you check references.  Plus, it's often quite expensive to get that type of evaluation.  I cannot remember exactly when it was, but sometimes in the past two weeks we posted an awesome workbook on the Facebook BrainParenting site that was the only place I've ever found that sells workbooks that you can use to do vision exercises with your child!  If you go there and scan backwards, you can find it, and I'll look again.

All of the things that you mention are developmental things.  They do not indicate that you need to drug your child immediately, although it will of course give both you and the teachers an immediately easier child to deal with.  Ahem.  However, we all knew that parenting was challenging when we signed up for it, didn't we!  :-)

Good luck!

cat

ps: one other very interesting vision tracking exercise that's free is to take a child and put them into a desk chair.  Turn the chair in a circle, taking a full minute to do so. This will cause them to have to change their vision.  It's very hard to find free exercises for this type of thing, but that's why we're here.

[Triniity]

hi, 

just quickly. her visual problems are not "visual" but in her brain. it's called raum-lage-wahrnehmung in german, it would be room-positioning-recognition. i don't really know what the translation would be. 

she does not really know which groups of letters are one word on the page, or one line. That makes learning to read difficult.

i've never heard about developmental ophtamologist - i don't think we have that here ??

[aishamama]

Originally Posted by Geofizz 


A good starting point might be the book Smart but Scattered. Your 6 year old might be on the young side for the specifics, but the book might give you a useful framework from which to start. The chapters on emotional control were very eye opening for me.
The book is written for parents of kids whose executive funtion isn't matching their other performance in life,but aren't so severely impaired so as to fit an ADHD diagnosis.

Thank you for writing this book recommendation. This is exactly what the issue with my son is.   My son is still 6 and everything you've written in your posts all in this thread has described his situation perfectly. I am going to get this book!

[aishamama]

Originally Posted by dkorovikov 

I think Geofizz is right on the money.

Testing a 4 year old for giftedness is... not ideal. In pure theory, intelligence tests are supposed to measure a child's intellectual potential, not how well / how much they've learned, but in reality that's pretty damn hard to assess (and some would argue not the point) so every intelligence test ends up having some influence of environment / experience. I say this because the problem is especially bad for young children who have a huge amount of variability in terms of life experience. A kid who is read to every night ends up having a much higher vocabulary than one who is not. In turn, this ends up being measured as higher intelligence, but we can see that this is the result of experience more than something internal to the child.

Testing a 4 year old for ADHD is also tricky. It's certainly doable and necessary in some situations, but they aren't that common. 4-year-olds, by nature of being 4, are given a wide latitude of acceptable off-the-wall behavior before we can confidently say there is a problem above and beyond what a teacher/parent/child can deal with, and it's sufficiently bad to warrant intervention. So maybe an ADHD diagnosis is warranted, but it requires quite a bit of attention problems to warrant at that age.

Testing a 6-year-old for giftedness is somewhat better, though still perhaps not ideal. Same with ADHD. You said your child has a learning disability-- by which criteria is this assessed? I ask because some states still use a discrepancy method in which they see if there's a gap between intelligence and academic achievement and if so consider that a learning disability. While the method has some advantages, it also has flaws. For example, say your 6-year-old has a 98th percentile IQ. They're keeping up with the class, but not going ahead or anything like that. They also aren't that perfectionistic (or maybe even have attention problems). So when they take tests, they may end up scoring somewhat worse than their knowledge reflects. On an achievement test, this may end up making them look average in terms of academic achievement when compared to same-age peers, because their giftedness doesn't magically endow them with higher grade level math knowledge and their attention problems limit their ability to fully demonstrate their existing skills. That could be a discrepancy large enough to constitute a learning disability, despite the fact that the child has no specific limitation or delay in skills pertaining to an academic area. Just some food for thought.
 

My 6 year old experienced this scenario this year to a T, except we know my virtue of personal interviewing in reading etc in a special format that he has very high reading and high-er math skills but you'd really never know that by his achievement testing. Spending time with him, it's very obvious.  The reading specialist came to his school and measured his lexile and put him at 620 at the beginning of First grade, however, he was supposed to be in Kindergarten by age. The reading specialist was really floored when she spent some time with him.  At the end of the year, on his standardized testing it put his lexile measurement at 500. I know that is wrong because he reads me books several grades ahead of his grade.  We just went through so much this year.  

[pumpkingirl71]

To me, a "globally gifted" child would not get bored and act out.  They would be able to process what was going on around them and do just fine.  But most super high IQ kids are not in that boat.  Emotionally and socially, they are just not as advanced.  I don't think it is really boredom.  More like the inability to process.

[Louisw]

Originally Posted by Triniity 

They have been tested for ADHD and both been diagnosed. The IQ Tests showed that both are gifted as well, Ds is still quite young for such a "diagnosis" I believe, and in DD they found a learning disability as well, which makes it difficult for her to do these kind of tests, so she apparently even more gifted because the IQ is false low. 

How do I keep them happy and engaged? 

IMO you are lucky. Sometimes ADHD may be "vaccine" injury.

You have bright kids; they are going to get into LOTS of trouble; they are going to tax your resolve and you are going to LOVE it. Teachers are going to have trouble with them; authority is going to have trouble with them; they will be accused of not being team players but they will know more about teams than their accusers.

How do I keep them happy and engaged?

Teach one French and the other German then have them teach other their new language. Do this as early as possible as kids have the best ability to learn a new language.

Start with simple jig-saw puzzles and see how far they can go.

Give them free access to the internet and monitor their viewing to only include what you approve. If you are not careful they will be producing porn movies and earning more than you . LOL

"A new study reveals that healthy kids who take Ritalin have a whopping 500 percent greater risk of sudden death. These aren’t kids with pre-existing heart conditions. The results would have been worse if they were included. The same study that found Ritalin stunts kids’ growth also found that it has no beneficial effect on behavior over a three-year period.”    Doctor Al Sears MD, Note most schools receive about 1000 dollars/year for each student they can snare into the drug program

"Think of an absentminded professor who can find a cure for cancer but not his glasses in the mess on his desk. These are the inventors, creators, poets -- the people who think creative thoughts because they don't think like everyone else." Martha Denckla, M.D., Director of the Department of Developmental Cognitive Neurology at the Kennedy-Drieger Institute at John Hopkins

The Wildest Colts make the Best Horses

[Adaline'sMama]

Originally Posted by Louisw 

IMO you are lucky. Sometimes ADHD may be "vaccine" injury.

Again, with the it's all the mom's fault.

Seriously, ADHD is a vaccine injury? Why is vaccine in quotes here?

Do you have any proof of this (that doesnt come from your website, and is from an accredited doctor?)

[aishamama]

Originally Posted by Triniity 

Hi, 

this might get a bit complicated. I am a bit lost here. I naturally wrote a lot about my kids here. However, I did not find a real solution yet. 

They have been tested for ADHD and both been diagnosed. The IQ Tests showed that both are gifted as well, Ds is still quite young for such a "diagnosis" I believe, and in DD they found a learning disability as well, which makes it difficult for her to do these kind of tests, so she apparently even more gifted because the IQ is false low. 

I read about giftedness and not getting enough input and therefor acting as if ADHD. Would the tests still show the ADHD than? Or is this a proper diagnosis. I am so unsure. And how do I work with it now? DD is able to concentrate very well if interested, but if it a little bit boring she just.does.not.concentrate. And the beginnings are not really exciting, mostly. Like learning how to play an instrument or like learning a language. It is fun as soon as you actually realize you learn something, 

How do I keep them happy and engaged? 

Anybody here with the same kinds of problems?

I commented under geofizz's post.  I thought it might be relevant because it described exactly what happened to my son. 

If my son finds the work boring and tedious, it is torture for both of us. I have to stay on top of him. He turns a 10 homework into a long drug out hour or two thing. It makes me crazy inside. For him though to be fair, it's mostly the writing. If I make him tell me the answers orally, he shoots it off. So, we do have our own issues. I believe he procastinates to get out of writing for his own issue reasons. So it might be boring, but I don't think that is his primary issue. I don't think he has ADHD extreme enough to be diagnosed, but for whatever reason he does get lost in thought and wants to do anything else but at the moment's work.  Now he is really figety and such but not that extreme.

Keeping them engaged.  

I would have pegged my 4 year old to have ADHD according to how he was acting a few months ago. However, he is only 4 and I think this age deserves some patience and time to develop. DS1 wasn't like him in how physical he was so it through us for a loop, plus I think lack of stimulation at school was creating issues. Now I am able to spend time with him and see just how far he's grown academically and I'm amazed. I never would have thought he'd be like this. So I do think lack of engagement for our family is just torture time. They do find things to do, but it won't be what I would prefer :)   They start building forts and castles out of all of the blankets and odd pillows, making giant messes lol.

So I stumbled upon things that work for us.  DS1 doesn't like puzzles at all. He doesn't like anything to solve. He doesn't get the least bit of thrill from it. But ds2 and ds3 LOVE puzzles and are so good at them. Last week I bought some puzzles, actually for ds1 thinking ds2 can't sit still and that ds3 was too little (2). How surprised I was. DS1 hate it, ds2 and ds3 have the most amazing puzzle making skills ever and they will sit for it till it's done. Sudden peace overcame us all.  DS1 likes to cut things and do art and draw. So I let him go to town with that. He made his own (fake) camera / telescope combo thingy. 

I got them a Reading Eggs subscription and they all will play with it, even the 2 y/o.  DS2 and DS3 really enjoy puzzles on the computer and in person and they like memory games, shape games that comes on starfall where you have to match the shape to what they put but on the oppposite side etc. Basically anything and everything they can unscramble. Ds2's favorite toy is a real screwdriver if that tells you anything about him. He's the one who takes everything apart and puts it back together. So that keeps him very busy. Thank goodness we don't use remotes. 

Basically I provide a few activities they like and then I let them entertain themselves. DS1 loves anything to do with animals, weather, Earth, etc so I let him watch National Geo movies and Dr. Brady Barr. DS2 and DS3 kind of hate him for that. They think it's the most boring things ever. I fall asleep watching the animals in the grasslands sitting around but ds1 loves it. 

Engaged in schoolwork is a different issue and a battle around here. So I have no words of advice. The times I've made learning fun, it went off better.  Now my kids are becoming fluent in three languages at the moment and they enjoy the activities surrounding this language acquisition. 

Sorry to make this so long.  I hope there was something helpful here. I am not so educated about giftedness.