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Possible 2E? ADD or Overexcitabilities?

1K views 12 replies 6 participants last post by  Linda on the move 
#1 ·
Hi everyone,

this is my first time posting here. I wonder if anyone has any experience with 2E testing?

Here's my story:

My 8 year old son was just identified as gifted via the WISC-IV with Very Superior scores in many of the sub-tests. However, he had much lower scores (Average) for working memory and processing which translates to having problems with attention. The Psychologist gave me a brief overview of the findings and said he'll explain in detail in our next meeting. he did mention that "in other states" my son would be twice exceptional, gifted with ADD (he never used the phrase ADD but that's how I interpreted "attention issues" and "twice exception".

So here's my issue. I've never seen evidence of attention issues though he has pretty bad anxiety around math and new challenges that he feels like he "should" know. He saw a psychologist for six months and sees the guidance counselor at school for anxiety. The psych who tested him said that he didn't think he has anxiety just attention issues.

Is ADD diagnosed with average scores if the rest of the subtests are that much higher? So is it a relative score that earns you the distinction of ADD?

He does also have a very intense personality...in my reading I've come across Dombrowski's theory of 'overexcitabilities' in gifted kids...they are very intense in their reactions to things. For example, my 8 year old teared up when telling me about Martin Luther King Jr and how he's no longer with us, or he starts crying and practically hyperventilating if he's not happy with an art project or has to do a math worksheet.

I wonder if anyone has had experience with ADD being diagnosed but found out it was anxiety or just emotionalism?

I also wonder if I'm questioning the attention issue because a part of me doesn't want to think that he does have that or if I just genuinely don't see it. In boy scouts for example, he is clearly one of the better behaved boys, paying attention, staying on task, not running around...

I'm waiting for the Psych to call me back to schedule an appointment (our first one we had to cancel due to illness) and I'm losing my cool!!!! (the apple doesn't fall far from the tree, can you tell?)

Geez, I know this was long but if you have any thoughts about any of this, I'd love to hear:)
 
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#2 ·
Well, ADD-innattentive (without hyperactivity) doesn't tend to have the in-your-face behavioural symptoms that most of us tend to think of when we think of attention deficit disorder. Often it presents more as absent-mindedness, lateness, forgetfulness and difficulty re-directing attention. And anxiety can be a symptom of it.

But the converse is also true: anxiety can look a lot like ADD. It's tricky. And there isn't a good test for ADD. It can't be assessed like IQ. It's usually based on a combination of behavioural questionnaires and particular patterns of strengths and weaknesses on IQ subtests and overall verbal and performance scores. The testing might hint at the possibility, but you can't make the diagnosis that way.

So that's what I'd ask the psychologist about when you go back: to what extent could the attention issues be the result of anxiety (particularly anxiety generated in the evaluation situation by his difficulties with processing speed and working memory). And what should you being doing to clarify the possibility of an attention disorder.

The important thing to remember while waiting and trying not to lose your cool is that the testing doesn't change anything about your son. He is still who he is. You might end up with information that will help you and him and his teachers, but he's still the wonderful unique kid you know so well. That doesn't change, no matter what a psychologist has to say about him.

Miranda
 
#3 ·
Thank you Miranda! I appreciate your input very much! You are so right about my son being the same person he always has been.

Part of why I'm trying to figure this out is I'm looking at putting him in a different school next year. The school system he's in doesn't have any gifted programming until fifth grade. Plus he's not fitting in well with his peers. The Psych called him "quirky" and told me he was at risk for being bullied in middle school. I was like, try First grade!

We're lucky though, there is a state funded school exclusively devoted to gifted kids about 40 minutes away from us. I've enrolled him and he was accepted! Which is a big deal because you have to be tested and then take your place in line...but he has a spot for next year! however my husband is not sure that he 'needs'that drastic of a change...it will require either us moving or a long commute. I'm all for it because the shcool is amazing. but my husband wants to check at schools closer to home, which is why it's important to get a Dx.

I know I just need to wait for the psych to call me back!! I am just impatient:))

Thanks again for your response Miranda- you laid it out clearly for me so I can be a little more focused in my meeting with Psych

:grin:
 
#4 ·
I cannot find a reference, but it's common for kids with high IQ to have variability amongst subtests. The WISC IV tests four broad areas, and it's most rare to have a score that is balanced and high, versus high in one or two and average in others.

What you've learned is that your kid has a ferrari engine (high VCI and/or PRI) and honda tires (average processing and/or WM). He will be fine, as his honda tires are reliable and high quality. It will make some things more complicated than if his ferrari engine had ferrari tires, but he will be great all the same.

I wonder if the psych is looking at this as a discrepancy score diagnosis. I don't think that's the end of the exploration. If there is indication of an attention issue (inattention, rather than hyperactivity (ADHD-I), then further assessment needs to be done (scales completed by parents and teachers). But "ADHD" as a label is just a cluster of behaviours, without view of etiology. It could be anxiety, or OEs (which may manifest as anxiety), or stage of development, or....

Here's something to read about IQ testing:
http://www.negifted.org/NAG/Spring_Conference_files/Assessment Handout 2013.pdf

You might also like Webb's Misdiagnosis and Dual Diagnosis of Gifted Children.
 
#5 ·
Thank you Joensally! This is really helpful! I feel like I'm twisting in the wind here- thank goodness for you and the rest of the mothering community. Every issue I've had, I've come here to get info and support and the mamas in this community always deliver. Mama Power- it's something to behold!:wink:
 
#6 ·
What testing, besides IQ, has the psychologist done? Did you fill in forms that you bubbled about his behaviors in different environments? How was his teacher involved? Did the psychologist consult him/her? Have her fill out forms? Did the psychologist observe your son, or video of him, in other environments?


ADD/ADHD cannot be diagnosed using an IQ test. Unless he did other stuff that you aren't mentioning, he doesn't have enough information to diagnosis it.


I have a DD who is 2E -- both gifted and on the autism spectrum. She also has a social anxiety disorder comorbid with autism. She has a HUGE (40 point) range her in IQ, and no one has ever suggested she has ADD/ADHD. Her anxiety manifest as full blown panic attacks.


(I suspect that my other DD is border line for ADD - inattentive type but never had her tested because she is smart enough to work around it).


I'm wondering how well the psychologist got to know your son before deciding that he doesn't have anxiety.


Another thought -- what is your relationship with his teacher like? Could you just call and talk to her, and set up a meeting for a few minutes. If you have a decent (no drama) relationship, and I would ask her if she sees any sign of attention issues, and if so what. This is a tricky one though -- in some districts, teachers cannot imply that kids have ADD/ADHD because it is a medical diagnosis. This is why I recommend speaking rather than emailing (which would require that she put it in writing), and only talking to her if you guys already have a decent relationship.


On one hand, we sometimes don't see what we don't want to see, but at the same time, if your son actually has ADD/ADHD, it would show up in some way in some aspect of his life.
 
#7 ·
Linda on the move, thank you. That's just what I was looking for, some insight into the process of diagnosing. This psychologist has met him one time and we haven't had any kind of behavioral evaluation, though he asked for input from his teacher. the teacher has talked with me a lot about his anxiety (she has very little patience for it) but has never said anything about attention issues. All of his teachers have always said he gives every single assignment 100% and is very conscientious...

Anyway, I appreciate your input. Wish you and your girls well.
 
#8 ·
Thanks! My kids are older. My 2E kid is now in community college and doing well there. This stuff gets easier.


I would question a diagnosis based on a single assessment that does not line up with what you see at home or what his teacher sees at school. Although I'm a big fan of appropriate diagnosing and labeling when it functions to get kids what they need to reach their potential, I'm leery of labeling kids with things if it isn't clear that the label fits the child, or the label serves no purpose for the child.
 
#11 ·
Well, it's true is can be problematic for him if his processing and working memory scores are much lower than his other scores. But you can't diagnose ADD with an IQ test. Some patterns are more common in kids with ADD or ADHD, and may suggest seeking more testing. But they aren't definitive and not all kids even show that sort of pattern. My daughter, who has Aspergers & ADHD-combined type actually scored really high in working memory; even her processing speed was in the Superior range (though well below her other scores). Diagnosing her ADHD involved multiple tests and a great deal of information on her behavior in various situations, because ADD is actually a catch-all label for certain patterns of behavior.

A child with low PSI and WM but high VCI and PRI may have a hard time showing what he knows and get frustrated because he knows much more than he's able to demonstrate. This seems like maybe something that could cause some of the issues you've seen, which sound like they might be described as performance anxiety. Have either the psych you worked with or the tester had much experience with gifted kids? It's not uncommon for gifted kids to have processing speed that's lower than their other scores, though it sounds like your scores have a really BIG gap.

When you meet with the psych and get the full results, make sure he gives you a GAI score in addition to the regular full scale IQ (FSIQ). The GAI is a more solid indication of ability for a child whose PSI or WM scores are very discrepant.

Also I have to say I think the "in other states" comment is weird. Twice exceptional isn't a label handed down by the state, it's a term that describes a gifted child who also has some sort of learning disability or other disability. Was he perhaps referencing how your state/school district actually deals with 2E issues on a practical level?
 
#12 ·
Aufilia, the first psych did not have experience with gifted. The second one does and actually already gave me his GAI along with his FSIQ. I think you're right about the other states comment being something related to state practices but haven't been able to google my way through that concept to see how my state does or doesn't deal with 2E kids differently.

My son is currently on a "I'm stupid" kick that bears out your suggestion that his mismatch causes frustration. He's highly stubborn too, so when I explain in every way but Swahili that he isn't stupid he says I'm just telling him that so he'll feel better. So frustrating!
 
#13 ·
When it comes to special education, different states define some terms slightly differently. For example, the definition of "intellectual impairment" varies a little from state to state, and some states don't define it at all.


However, ADD/ADHD is a medical diagnosis, not an educational diagnosis, so it isn't defined by state law any more than the definition of strep throat or diabetes is defined by state law. A child with any medical diagnosis that impairs her/his ability to learn in school has right to special education services under federal law (IDEA 2004 if they need alternate goals or special services, and Section 504 of Americans with Disabilities Act if they only need accommodations).


Gifted education is a whole different animal than special education because there is no federal law. Every state (or district) can do what they want. They can define giftedness however they want, provide what ever they want, or they can do nothing.


I haven't seen anything on any laws related to 2E in any state. It isn't discussed in the federal laws, and it isn't a legal category in any of the states we've lived in. Kids qualify for services or accommodations based on their disability, and then quality for whatever gifted programing is available for them that is appropriate for them.
 
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