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<p><span style="font-size:medium;"><span style="font-family:'times new roman';">...with family harmony, time, and money disappearing and I am still not sure how to navigate it.</span></span></p>
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<p><span style="font-size:medium;"><span style="font-family:'times new roman';">I have posted recently about DS’ behaviours that make family life stressful at the moment:</span></span></p>
<p><span style="font-size:medium;"><span style="font-family:'times new roman';">Compulsive-seeming chatchatchatting and wriggling which keeps him wired all day and keeps him from falling asleep at night and winds up DD (and us!), waking up every night to move in for a cuddle (making for even less sleep for me and being really in the way when I need to nurse DD...), his mouthing phases (currently much better, but I’m sure it will come back), his need to grab, yank and chew on my hair during the day and in order to fall asleep,  his bumping into other kids, his spiralling out of control when socially overwhelmed into wild and aggressive goofiness he can’t seem to snap out of even when other kids complain and tell him off. I am trying to introduce a better sensory diet and I feel that fish oil is helping, but I don’t think it’s going away.</span></span></p>
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<p><span style="font-size:medium;"><span style="font-family:'times new roman';">Most of you suggested sensory issues, and some felt a proper eval for SPD was in order.   </span></span></p>
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<p><span style="font-size:medium;"><span style="font-family:'times new roman';">I could tell from pointed questions the pre-school teachers were asking about his ability to settle down and focus when he started last year at 2y10m that they suspected AD(H)D but they haven’t said anything since. I completely dismissed it because he was able to focus, for instance, on finishing puzzles for 5 yo at the time, feeling that if he sometimes appeared unable to settle down at preschool was about being socially overwhelmed and distracted in a 3-6 class and about not being engaged by what they offered to the little ones. Now that he’s considered a second-year, it appears to be much better. He still seems to be behind socio-emotionally to me when I watch him play with others, so this may be about wanting to play with much older kids, too. But when we had two 6 yo brothers over recently, they were all participating nicely in baking cookies, though wriggling and shrieking with excitement, but when I could tell they were losing it and turned them loose to play, the brothers settled down with his playmobils but DS lost it completely, shrieking, running, pushing, taking toys away and throwing them in the waste paper basket. I had to keep pulling him out and finally resort to putting in a video about volcanoes. Rapt attention.</span></span></p>
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<p><span style="font-size:medium;"><span style="font-family:'times new roman';">So, should we look at AD(H)D? Or is this giftedness and asynchronous behaviour?</span></span></p>
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<p><span style="font-size:medium;"><span style="font-family:'times new roman';">However: he gets rave reviews about his participation from his foreign language teacher who teaches a weekly half-hour class at pre-school (for which he’s been entered a year early) about his participation and ability to follow directions from the Montessori teacher that teaches a weekly K class (for which he’s been entered two years early). He loves music school (for which he’s been entered one year early). At his 4yo well-baby visit, the assistant gushed about how bright he was and how well he was participating. So did the pottery teacher at the drop-in class we went to last summer when he was still too, encouraging us to sign him up for a reagular parent-and-child class (“um, but this says he has to be four..?”-“oh, isn’t he?”).</span></span></p>
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<p><span style="font-size:medium;"><span style="font-family:'times new roman';">He was a preemie, needing oxygen in the NICU, used to develop assymetrically and is still somewhat hypotonic and uncoordinated. I thought maybe mild hemispheric cerebral palsy which might explain behavioral issues too, but a PT evaluation showed no assymetry, just the low coordination.</span></span></p>
<p><span style="font-size:medium;"><span style="font-family:'times new roman';">SPD?</span></span></p>
<p><span style="font-size:medium;"><span style="font-family:'times new roman';">I also took him to an osteopath my PT recommended for “working miracles with preemies who may need their cranial bones realigned”. So the</span></span> <span style="font-size:medium;"><span style="font-family:'times new roman';">osteopath took down his name, address, date of birth (all without my involvement except for the postcode). She asked him whether he knew why he was there and he repeated what I had explained to him in the car, namely his difficulties falling asleep. I had explained it to him as an objective problem, but she asked him specifically whether this bothered him and he said “yes, because I am tired and want to fall asleep but can’t because my muscles still wriggle and my mouth still chats” (which was new to me, too). When he started to explain about his prematurity and attempted to describe the placenta malformation that may have contributed, she looked at me and asked whether we’d ever had him tested. She then did what osteopaths do and to my and her surprise said all was fine and she couldn’t do anything at all. However, he reminded her extremely of her own little boy, very bright, diagnosed with AD(H)D, now attentive type but formerly hyperactive, who was now in fifth grade and whom, after much agonizing and trying everything else (being a wholistic health professional, after all) she was now putting on medication because the school situation was getting untenable (apparently, he is severely diyslexic, too). She recommended (as a mother, not as a professional, conceding she wasn’t trained in diagnosing this at all, though DS, as if for her benefit, had descended into thorough goofing-off mode by then) a thorough evaluation for AD(H)D and participation in a study conducted by the local children’s hospital about high-dosage fish oil. No, she said, in her experience being able to focus wonderfully when interested didn’t make a difference, could still be AD(H)D.</span></span></p>
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<p><span style="font-size:medium;"><span style="font-family:'times new roman';">So, is it AD(H)D? SPD? Giftedness and asynchronous behaviour? Should we have him evaluated now? Should we wait? What's the priority? How do I get our ped to take me seriously when he's always an angel in the office? And how do you prevent evaluation fatigue and him thinking there must be soething seriously wrong with him?</span></span></p>
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<p><span style="font-size:medium;"><span style="font-family:'times new roman';">Or am I totally overthinking this and he’s mostly just a young four, with some sensory needs and a new baby sister?</span></span></p>
 

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<p>An osteopath isn't who you see about SPD, you need an evaluation from an occupational therapist.  </p>
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<p>Much of what you describe is pretty much age appropriate behavior (since you say he started school last year at 2y10m, I figure he is a just turned 4 yo now.  Also, depending on how premature he was, adjusting for that puts him at a older 3yo.)  Being possessive about toys is pretty typical preschooler behavior.</p>
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<p>When people say concentrating at some things or sometimes doesn't rule out ADhD, they are mostly talking about highly stimulating things such as TV.  You are saying he concentrates in a wide range of different types of activities.  I'm not saying your DC doesn't have ADhD, since I am not qualified to make that determination (especially over the Internet <img alt="lol.gif" src="http://files.mothering.com/images/smilies/lol.gif"> ,) but from what you describe I don't see an evaluation for it as a top priority.  Most Drs won't dx it this young anyway.</p>
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<p>have you gotten around to reading <span style="text-decoration:underline;">Misdiagnosis and Dual Diagnosis of Gifted Children and Adults</span>?</p>
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<p>DS was very wild a year ago (just a little younger than your DS,) and had problems in school with it.  A few months of OT, a year to grow and mature, some well planned activities that are particularly good at filling his sensory needs (I can't say enough about how great bowling is for a sensory seeker) and DS is able to sit still in school without problems.</p>
 

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<p>I would say an eval wouldnt hurt and may bring you some more information.</p>
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<p>BUT at a young 4, very very few Dr will dx ADHD unless it is extreme and/or aggression is involved. There is a wide range of 'normal' activity between ages 3-4 and some kids are more active and then later settle down and learn to focus/direct their energy and other will later be dx as ADHD.</p>
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<p>SPD is also a potential concern. You would need an OT eval--they would look at his ability to tolerate texture, if he is hypo/hyper sensitive to sounds/touch/movement, his ability to handle his body in space.</p>
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<p> I would hesitate to compare him to a 6 yr old at all. There is a vast maturity difference in those two years. Personality also plays into it at times.</p>
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<p>I have a DD that we suspect is gifted and has SPD (had OT for it). She improved a great deal between 3.5 ( on an IEP and considering special needs preschool due to SPD behaviors) and age 5 ( no longer on an IEP and in a PReK classroom) on her sensory seeking behaviors. Do we still see quirks, yes. Does she have a better handle on dealing with them, yes. Can she verbalize her feelings better that leads to less melt-downs,yes. Is she still have issues that are not quite on par for her age, yes. Is she have asynchronous development, yes. (she can read at 2-3rd grade level, do late 1st grade math, has an exceptional vocabulary, but still can not ride a bike, chews on things, has sensory overload easily, fatigues and takes a nap daily). She was a preemie as well and has had an abundance of OT & PT therapies when she was 6 months to 4.5 years. </p>
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<p>Her twin is the one that does.not.stop.talking.at.all, and there is no way she has ADHD or SPD. It is just her personality. She can and does focus intently on things (crafts, puzzles, etc), but can be very very 'bouncy'. She also is at the same or higher academic levels as her sister. She has trouble falling asleep and is very wiggly. Her teacher states that at times she can dominate activities, but she does well at school. </p>
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<p>You have a couple of options. You can go for an eval through the schools (free), ask for one through your insurance, seek private evaluation and pay out of pocket, or consult your Pediatrician with your concerns and see what she reccommends. Or wait and see what changes over the next few months.</p>
 

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<p>Um. Do we have the same child? i'm reading your post just nodding my head over and over. I just got through posting something similar a few days ago.</p>
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<p>my kid is super smart, can read a bit (but rarely if ever shows it) never forgets anything, repeats sentences or phrases over and voer or just follows me around chattering like he can't stop, is insanely wild, flings himself all over the place, tears the hosue apart, runs around, is verbally precocious.</p>
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<p>Someone here suggested to me that is could be sleep related, because he snores and wets the bed often (although he is just turning 3 so wetting the bed is not THAT worrisome at this point). I have taken fish oil before (I have ADD) and not noticed much of a difference but then I suck at taking things consistently so that might be why...</p>
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<p>Anyway you might want to check into the sleep thing, if he snores or wakes up a lot at night, that could be related. I know its really frustrating when the only thing consistent is the inconsistency of the behavior.</p>
 

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<p>Hi Tigerle, I don't have the focus right now for the long reply I'd like to provide, so I'll keep it short but wanted to send some support over the internet to you.</p>
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<p>DS is 8.  He absolutely has SPD, is EG, has vision issues, "LDs" (I have issues with this, but I'll expand later), dysgraphia (which is improving!!!), meets the criteria for ADHD.  I'm probably missing something.  :) </p>
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<p>The three points I wanted to make were a) definitely get to an OT - they're great.  If it's OEs related to giftedness rather than SPD the OT can still help with a sensory diet that will help him;   b) ADHD is a bit strange - you can't diagnose until age 8 typically, and it's supposed to only be diagnosed when other causation is ruled out (and giftedness and sensory issues can also cause ADHD-type behaviours), and c) DS was really challenging for a lot of years, but we held strong that we would help him manage his intensities and ameliorate his challenges to his benefit, but we embrace him as he is.  These kids are really challenging to navigate through the school system, but they are an absolute joy.  I used to really, really worry about DS when we didn't have names and explanations for things and I felt hopeless at times.  The Eides note that they see very few SPD symptoms in their patients over 10 - either they've largely outgrown it or have learned to manage it.  DS, at 8, has learned to better manage his intensities, we have a better idea of what's going on (he's a complicated guy), and we're all enjoying life a lot more of late.</p>
 

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<p>This sounds similar to ds1 a year ago. He's so much easier this year. He's 6 now. He is a chatterbox, wriggles, hard to fall asleep, gets totally hyper when there is a lot of sound and movements, frequent headaches etc. I never thought for once that he could be ADHD, but I did feel his self-regulation seemed to have taken a complete nosedive since he entered preschool. We sent him for OT evaluation, vision evaluation and dyslexia evaluation. Later, after much hesitancy, we sent him to osteopath for cranium adjustment (not sure what you call it!). He was stuck in the birth canal for 2 hours and was delivered via vacuum and subsequently developed a flat patch on his skull as he always returned his head to the same spot even though we rotated his positions.</p>
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<p>Feedback:</p>
<p>Some SPD, but I didn't feel that OT helped. In fact I felt he was harder to manage after each session because of his aroused state and the OT comes highly regarded. But the recommendations for heavy weight activities were helpful, though instead of home activities, I simply upped his gym, swimming etc.</p>
<p>VIsion issues. Vision therapy helped.</p>
<p>Dyslexia - inconclusive, but definitely needed multisensory approach as he had poor sound processing and sequencing. I felt that he was also more comfortable in class once the vision and reading were taken care of. (sounds like a given doesn't it?)</p>
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<p>All these were costly and took us to a certain level and then we hit a plateau. Finally went to the osteopath. At the first session, the osteopath said we will see dramatic difference including in his self-regulation - and by the third session we did! I can't believe it but we did! It could be a matter of maturity, but timing wise, it totally coincides. Even my MIL commented on the difference in his improved tolerance level and patience. After the first session, he could ride a 2 wheel bike overnight, no kidding. He is now badgering me for rollerblades, which I am still in disbelief over. This is the kid who didn't know how to use a swing. It took 3 painful weeks to learn that, more to learn how to turn the pedals of a training bike.  Recently I took him back for a review session at the OT, (one year since his first assessment) and she was surprised to note that in many areas, he had leapt from borderline to the 90th percentile. His vision processing is still very low (3rd percentile), but DH and I feel that this is something he is playing catch up on since he has had to contend with poor binocular vision until about six months ago when we switched our vision place.</p>
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<p>We have dropped all other therapies except for the osteopath, and keep up with activities that are helpful for developing vision. .   </p>
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<p>It may take a while to find what works, but take heart, things DO get better as they grow older. </p>
 

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<p>I'm cautious about people who want to diagnose gifted kids with ADHD.</p>
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<p>Both gifted kids and kids with ADHD have late maturation of the pre-frontal cortex. That leads to some very squirrelly behavior, but for gifted kids (and maybe for non-gifted ADHD kids, too) that allows them to continue learning in a very rapid way. The squirrel behavior is a side-effect of their gift.</p>
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<p><a href="http://eideneurolearningblog.blogspot.com/2010/01/cognition-without-control-adhd-gifted.html" target="_blank">http://eideneurolearningblog.blogspot.com/2010/01/cognition-without-control-adhd-gifted.html</a></p>
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<p><a href="http://www.fed.cuhk.edu.hk/~lchang/material/Evolutionary/IQ%20and%20cortical%20thickness.pdf" target="_blank">http://www.fed.cuhk.edu.hk/~lchang/material/Evolutionary/IQ%20and%20cortical%20thickness.pdf</a></p>
 

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Discussion Starter · #8 ·
<p>Thank you for your input everyone! I'll try to process this in order...</p>
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<div> Much of what you describe is pretty much age appropriate behavior (since you say he started school last year at 2y10m, I figure he is a just turned 4 yo now.  Also, depending on how premature he was, adjusting for that puts him at a older 3yo.)  Being possessive about toys is pretty typical preschooler behavior.</div>
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<p>DS turned four mid-Oct., due date was late Nov. So mildly premature and yes, very young four really. It's just that some of the behaviours seem to be deteriorating, and it appears so out-of-control. Last year, there was more rigidity, and meltdowns, and these very stressful (for me, too!) fear-of-death-phases, but he seemed calmer, and more focused on doing stuff like puzzles, being read to, etc. Not that he can't do it now, but it's getting rarer. And it wasn't so much that he was possessive about toys (which I agree is perfectly age-appropriate) but that he was so wild about it and seemed to feel the need to destroy his friends' play, even though appearing to want to play with them at the same time, if that makes sense. Probably total sensory overload at the time...</p>
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<div> When people say concentrating at some things or sometimes doesn't rule out ADhD, they are mostly talking about highly stimulating things such as TV.  You are saying he concentrates in a wide range of different types of activities. <span style="display:none;"> </span></div>
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<p> This is very interesting information, jibes with my gut feeling!</p>
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<div> Most Drs won't dx it this young anyway.<span style="display:none;"> </span></div>
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<p> And so does this! A number of you have thrown this out, and it is so helpful in sorting out priorities. I am planning to hold out on pursuing an AD(H)D evaluation until he is something like 5.5 or so (that would be just before the start of formal schooling in 1st grade), or until something else forces it upon us. (Of course I'll read up on stuff for myself, as I usually do...such as...)</p>
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<div> have you gotten around to reading <span style="text-decoration:underline;">Misdiagnosis and Dual Diagnosis of Gifted Children and Adults</span>?<span style="display:none;"> </span></div>
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<p> I've read some of it on google. I've got the Eide's The Mislabeled Child, which I promptly lent to the osteopath till next week, feeling so sorry for her boy with the double whammy of AD(H)D and severe dyslexia, as diagnosed...I'll check up on the AD(H)D section in both!</p>
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<p>DS was very wild a year ago (just a little younger than your DS,) and had problems in school with it.  A few months of OT, a year to grow and mature, some well planned activities that are particularly good at filling his sensory needs (I can't say enough about how great bowling is for a sensory seeker) and DS is able to sit still in school without problems.</p>
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<p> I remember your writing "he's just become dizzyingly asynchronous" and remember thinking "wait, this gets worse before it gets better?" Apparently it's getting worse for us, too...Again, he's got a year and a half to mature before school!</p>
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<p>I can hear DD, gotta run...</p>
 

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Discussion Starter · #9 ·
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<div> BUT at a young 4, very very few Dr will dx ADHD unless it is extreme and/or aggression is involved.</div>
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<p> the hugging/squeezing children from behind, the running at them and have them run off in fright, crashing into them, knocking them over and climbing onto them...sure looks like aggression. As I am writing it, I realize it sounds exactly like the sensory seeking behaviours described in "The sensational child". So far other little ones and preschool teachers seem to tolerate it (it tends to happen a lot more at transition times like pickup and dropoff I think, so i am often there and can interefere. Right now it is more a social problem than anything.</p>
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<p> I would hesitate to compare him to a 6 yr old at all. There is a vast maturity difference in those two years. Personality also plays into it at times.</p>
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<p>I try very hard not to! But it is a good reminder. The problem is that those are the children he is interested in and wants to play with (he arranged the playdate with the brothers himself)- playtime with younger kids who are less verbal tends to deteriorate even faster, as he cannot communicate witht them the way he wants to, and while they are more tolerant of wild goofiness, they may get wound up as well and feed into it, as it were. Older girls seem to have the most "calming" effect on him...</p>
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<p>May I take a totally OT minute to say how incredibly CUTE those brothers are? Two out of a set of triplets, their bigger and more robust looking sister has gone off to first grade while her smaller and more delicate brothers have been redshirted -  with their elfin faces, tousled hair and high-pitched voices looking and sounding for all the world like two hobbit children! Aww....</p>
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<p>I have a DD that we suspect is gifted and has SPD (had OT for it). She improved a great deal between 3.5 ( on an IEP and considering special needs preschool due to SPD behaviors) and age 5 ( no longer on an IEP and in a PReK classroom) on her sensory seeking behaviors. Do we still see quirks, yes. Does she have a better handle on dealing with them, yes. Can she verbalize her feelings better that leads to less melt-downs,yes. Is she still have issues that are not quite on par for her age, yes. Is she have asynchronous development, yes. (she can read at 2-3rd grade level, do late 1st grade math, has an exceptional vocabulary, but still can not ride a bike, chews on things, has sensory overload easily, fatigues and takes a nap daily). She was a preemie as well and has had an abundance of OT & PT therapies when she was 6 months to 4.5 years. </p>
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<p>Her twin is the one that does.not.stop.talking.at.all, and there is no way she has ADHD or SPD. It is just her personality. She can and does focus intently on things (crafts, puzzles, etc), but can be very very 'bouncy'. She also is at the same or higher academic levels as her sister. She has trouble falling asleep and is very wiggly. Her teacher states that at times she can dominate activities, but she does well at school. <span style="display:none;"> </span></p>
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<p> DS sort ouf sounds like a mixture between the two though he is not as far ahead academically. It is so VERY reassuring to hear about how maturity can kick in again  - especially after DS appears to have taken such a nosedive recently.</p>
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<p>You have a couple of options. You can go for an eval through the schools (free), ask for one through your insurance, seek private evaluation and pay out of pocket, or consult your Pediatrician with your concerns and see what she reccommends. Or wait and see what changes over the next few months.<span style="display:none;"> </span></p>
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<p> We live in Europe, so will have to go through the medical system, but our insurance is good. I feel that if things don't improve after Christmas we will go for an SPD eval at least. A friend pointed out to me that my stress level, being super-high at the moment, must feed into it, just as it makes DD wake up to feed almost hourly, and I suffer not only from lack of sleep from a severe lack of not having done our tax returns in addition to other end-of-year-stresses! Also that the bad weather recently made it hard for the kids to get outside and their share of exercise in - we'll go sledding this afternoon, I am determined!</p>
 

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Discussion Starter · #10 ·
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<p>Anyway you might want to check into the sleep thing, if he snores or wakes up a lot at night, that could be related. I know its really frustrating when the only thing consistent is the inconsistency of the behavior.<span style="display:none;"> </span></p>
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<p>Um. Do we have the same child? i'm reading your post just nodding my head over and over. I just got through posting something similar a few days ago.</p>
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<p>Knowing you're not alone helps, doesn't it?</p>
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<p> Someone here suggested to me that is could be sleep related, because he snores and wets the bed often (although he is just turning 3 so wetting the bed is not THAT worrisome at this point). I have taken fish oil before (I have ADD) and not noticed much of a difference but then I suck at taking things consistently so that might be why...</p>
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<p> In "the mislabeled child" they describe such a case, whose troubling behaviousr went away magically as soon as the child got oxygen during the night. Check it out! DS' bad sleep does not seem to bo physical though, as he breathes calmy and regularly, does not snore at all and when he wakes up he usually has a bad dream to relate and is afraid. The fish oil seems to help, things are better in the evenings. Frankly i am not sure whether I may not have some kind of undiagnosed ADD inattentive type myself (inability to manage my paperwork, see tax returns, lack of having done them, being a big symptom!) and I take the fish oil too and it doesn't seem to help me so far. Maybe it is really about the dosage! I shall find out more about that study the osteopath mentioned.</p>
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Discussion Starter · #11 ·
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<p>Hi Tigerle, I don't have the focus right now for the long reply I'd like to provide, so I'll keep it short but wanted to send some support over the internet to you.</p>
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<p> I'd love to hear more about how you managed when your DS was younger!</p>
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<div> The three points I wanted to make were a) definitely get to an OT - they're great.  If it's OEs related to giftedness rather than SPD the OT can still help with a sensory diet that will help him;  </div>
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<p> Yeah, we will. It's a New Year's resolution now!</p>
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<p> I'm going to put that one on the back burner. I did check up in the SPD books I've got, and there IS a high incidence of co-morbididty though, up to 60%. With prematurity boing a huge risk factor for both. AHHH!  I thought we'd left that issue behind but now I feel guilty all over again, wishing I had taken better care of myself, I might have been able to keep cooking him bit longer...</p>
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<p>and c) DS was really challenging for a lot of years, but we held strong that we would help him manage his intensities and ameliorate his challenges to his benefit, but we embrace him as he is.  These kids are really challenging to navigate through the school system, but they are an absolute joy.  I used to really, really worry about DS when we didn't have names and explanations for things and I felt hopeless at times.  The Eides note that they see very few SPD symptoms in their patients over 10 - either they've largely outgrown it or have learned to manage it.  DS, at 8, has learned to better manage his intensities, we have a better idea of what's going on (he's a complicated guy), and we're all enjoying life a lot more of late.<span style="display:none;"> </span></p>
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<p> Again, this is so very reassuring. Thank you!<span style="display:none;"> </span></p>
 

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<p>Ugh, this is frustrating... I can't seem to multi-quote today, even though I have several posts selected.  Sigh.</p>
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<p>Tigerle:  I would have him evaluated for SPD, for sure.  SPD causes a lot of behaviors that might've been labeled ADHD a generation ago, and it really is too young for an ADHD diagnoses anyhow.  Would you really want to be pushed to medicate a child of 4 with stimulants?  I think in nearly any case you would want to pursue therapy first. Focus wouldn't necessarily rule out ADHD, though -- hyperfocus is part of ADHD as well. </p>
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<p>This really hit me:</p>
<p>
<span style="font-size:medium;"><span style="font-family:'times new roman';">She asked him whether he knew why he was there and he repeated what I had explained to him in the car, namely his difficulties falling asleep. I had explained it to him as an objective problem, but she asked him specifically whether this bothered him and he said “yes, because I am tired and want to fall asleep but can’t because my muscles still wriggle and my mouth still chats” (which was new to me, too).
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<p><span style="font-size:medium;"><span style="font-family:'times new roman';">DD was re-evaluated by the school district for SPD a couple weeks ago and they also asked her if she knew why they were doing it.  Apparently she gave them a vivid and very accurate statement about her needs. One of the evaluators later told me and the director that she'd never had a child who seemed to self-aware and able to describe her issues.</span></span>  It is amazing and heartbreaking how aware our gifted little ones can be of their struggles.</p>
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<p>my kid is super smart, can read a bit (but rarely if ever shows it) never forgets anything, repeats sentences or phrases over and voer or just follows me around chattering like he can't stop, is insanely wild, flings himself all over the place, tears the hosue apart, runs around, is verbally precocious.</p>
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<p>Someone here suggested to me that is could be sleep related, because he snores and wets the bed often (although he is just turning 3 so wetting the bed is not THAT worrisome at this point). I have taken fish oil before (I have ADD) and not noticed much of a difference but then I suck at taking things consistently so that might be why...</p>
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<p>Anyway you might want to check into the sleep thing, if he snores or wakes up a lot at night, that could be related. I know its really frustrating when the only thing consistent is the inconsistency of the behavior.
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<p>FWIW I have found that sleep does affect DD's behavior but not in the ways I would expect.  If she sleeps poorly at night she doesn't necessarily act up in the morning.  But if she misses her nap -- oh, she is a MONSTER in the early evening.  If she misses her nap we literally cannot go out in public without causing a scene.  She clearly really needs that mid-day refresher to maintain any scraps of self-regulation.</p>
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<p>Interestingly, she and DH shared a bed over Thanksgiving, and he said she kicked him all night long, which makes me wonder if she's inherited my restless leg syndrome.</p>
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<p>
You have a couple of options. You can go for an eval through the schools (free), ask for one through your insurance, seek private evaluation and pay out of pocket, or consult your Pediatrician with your concerns and see what she reccommends. Or wait and see what changes over the next few months.
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<p>I wouldn't wait too long.  We did the 'wait and see' thing for awhile since I was pregnant and then we had a new baby in the house right as DD started to really have trouble, and I wish we hadn't.  We did start OT when the baby was about 6 months, but our insurance coverage is poor and I wish we'd done more earlier (before our insurance changed to this crappy plan we have this year). </p>
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<p>I would also suggest pursuing a couple paths if you can.  It's good to have a 'second opinion' and choices on how to proceed after a diagnosis. Next year we will be getting school district services and also private OT, because honestly, at 5, SPD issues are already potentially limiting DD's opportunities in school.  We are planning to apply to 2 private programs for Kindergarten and I worry that her behavior will prevent her from being admitted. Between the two services, we still only get the equivilent of 1 hour of OT per week.</p>
 

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<p>This sounds similar to ds1 a year ago. He's so much easier this year. He's 6 now. He is a chatterbox, wriggles, hard to fall asleep, gets totally hyper when there is a lot of sound and movements, frequent headaches etc. I never thought for once that he could be ADHD, but I did feel his self-regulation seemed to have taken a complete nosedive since he entered preschool.  </p>
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<p>I wonder what would happen if we got all those kids who sound so similar together IRL, whether they'd hit it off or hit the roof and blow up the house...around here parents are super cautious about self-contained gifted programs, preferring high-achiever programs all around because they feel that gifted programs tend to collect "problem boys" (yes specifically boys). Maybe they consist of twenty little ones like ours, that would make for interesting classrooms for sure! A joy, like Joensally said, but also a huge challenge...</p>
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<p>But the recommendations for heavy weight activities were helpful, though instead of home activities, I simply upped his gym, swimming etc.</p>
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<p> I make him push DDs stroller through the snow all the time now, and he's very whiny about it. I cannot say that it seems to help much, though it does keep him busy after transitions. We also took him sledding today, but the physical exhaustion just brought things to a fever pitch. Not sure how to proceed here, I think we need the OT eval on this one. The evening backrubs sure seem to help. </p>
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<div> All these were costly and took us to a certain level and then we hit a plateau. Finally went to the osteopath. At the first session, the osteopath said we will see dramatic difference including in his self-regulation - and by the third session we did! I can't believe it but we did! It could be a matter of maturity, but timing wise, it totally coincides. Even my MIL commented on the difference in his improved tolerance level and patience. After the first session, he could ride a 2 wheel bike overnight, no kidding. He is now badgering me for rollerblades, which I am still in disbelief over. This is the kid who didn't know how to use a swing. It took 3 painful weeks to learn that, more to learn how to turn the pedals of a training bike.  Recently I took him back for a review session at the OT, (one year since his first assessment) and she was surprised to note that in many areas, he had leapt from borderline to the 90th percentile. His vision processing is still very low (3rd percentile), but DH and I feel that this is something he is playing catch up on since he has had to contend with poor binocular vision until about six months ago when we switched our vision place.
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<p>We have dropped all other therapies except for the osteopath, and keep up with activities that are helpful for developing vision. .   </p>
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<p>I am glad to hear we weren't sent on a wild goose chase and that there <em>are</em> some kids whom osteopaths can help, even though it wasn't true for us. Well, she recommended bringing DD who can only fall asleep looking to the right and at least she appears to be improving, she's sleeping with her head turned to the left right now...</p>
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<p>It may take a while to find what works, but take heart, things DO get better as they grow older. <span style="display:none;"> </span></p>
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<p> Thank you, I am taking heart from this.</p>
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<p>Ugh, this is frustrating... I can't seem to multi-quote today, even though I have several posts selected.  Sigh.</p>
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<p>Yeah, the new editor is getting seriously on my nerves. Editing never works, either.</p>
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<p>Tigerle:  I would have him evaluated for SPD, for sure.  SPD causes a lot of behaviors that might've been labeled ADHD a generation ago, and it really is too young for an ADHD diagnoses anyhow.  Would you really want to be pushed to medicate a child of 4 with stimulants?  I think in nearly any case you would want to pursue therapy first. Focus wouldn't necessarily rule out ADHD, though -- hyperfocus is part of ADHD as well. </p>
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<p>Ah, I think I'd be very good at holding out on stimulants for years. Getting the thorough evaluation to come with the study and the high dosage fish oil for free would have sounded good though - that stuff's so expensive! but you've all thoroughly convinced me that just-turned-four is not the time.</p>
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<div> It is amazing and heartbreaking how aware our gifted little ones can be of their struggles.<span style="display:none;"> </span></div>
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<p>Yeah, that. i purposely did not talk about how this is affecting him socially to him or in front of him at all, because I think realizing this might really make his self-esteem take a nosedive.</p>
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<p>FWIW I have found that sleep does affect DD's behavior but not in the ways I would expect.  If she sleeps poorly at night she doesn't necessarily act up in the morning.  But if she misses her nap -- oh, she is a MONSTER in the early evening.  If she misses her nap we literally cannot go out in public without causing a scene.  She clearly really needs that mid-day refresher to maintain any scraps of self-regulation.</p>
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<p>I wish he hadn't dropped his naps as early as he did - almost two years ago! By the time he was three, he wouldn't even nap in the car, no matter how long the trip! i am still wondering whether we should move his bedtime earlier but he does wake up around 7 now as we want him to.</p>
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<div> I wouldn't wait too long.  We did the 'wait and see' thing for awhile since I was pregnant and then we had a new baby in the house right as DD started to really have trouble, and I wish we hadn't.  We did start OT when the baby was about 6 months, but our insurance coverage is poor and I wish we'd done more earlier (before our insurance changed to this crappy plan we have this year). </div>
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<p>I find it actually easier to pursue this now, as i am home with the baby and have the time to drag them both to all those appointments. By next fall, I want to be working again and it will be so much harder to set things up, easier if the things that are working are already in place. not to mention that I will be unable to work unless the sleep issues are better.</p>
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<div> I would also suggest pursuing a couple paths if you can.  It's good to have a 'second opinion' and choices on how to proceed after a diagnosis. Next year we will be getting school district services and also private OT, because honestly, at 5, SPD issues are already potentially limiting DD's opportunities in school.  We are planning to apply to 2 private programs for Kindergarten and I worry that her behavior will prevent her from being admitted. Between the two services, we still only get the equivilent of 1 hour of OT per week.<span style="display:none;"> </span></div>
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<p> Yes, I really want to get to the bottom of this <em>before</em> there is a problem with school. I am also planning on IQ testing at a late five (just before entering first grade, K is a pull-out program in his current preschool) to have a better idea about how that feeds into it.</p>
 

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<p>I'm cautious about people who want to diagnose gifted kids with ADHD.</p>
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<p>Both gifted kids and kids with ADHD have late maturation of the pre-frontal cortex. That leads to some very squirrelly behavior, but for gifted kids (and maybe for non-gifted ADHD kids, too) that allows them to continue learning in a very rapid way. The squirrel behavior is a side-effect of their gift.<span style="display:none;"> </span></p>
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<p>This research used to comfort me for a long time, when DS behaviour was still mostly about being squirrelly and having poor impulse control. however, recently the quality seems to have changed...it seems more out of control. Like he's not even trying to self regulate, and while he is still looking to us, particularly me, to help him self-regulate, he seems increasingly harder to calm. By the way, is there such a thing as self-regulation deficit syndrome? Because that would be a MUCH better way to describe it.</p>
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<p>And can someone tell me why I keep getting the error message "please enter something before submitting?"</p>
 

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<p>I also thought I should ask around a bit whether others are seeing what I am seeing...so i asked my inlaws who spend a lot of time with him and they confirmed that yes, they do see a new quality to his squirrellyness or goofiness, they agree that it seems more out of control and that it is harder to calm him down. however, my FIL insisted it was only during transitions and that he was doing very well whenever they were home, did activities ect.(my FIL used to be a high school physics teacher so is used to providing a stimulating but structured environment all the time - it's a bit like sending DS to be homeschooled!)</p>
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<p>I also got the opportunity to ask his preschool teacher sooner than I would have liked, because they phoned to tell me DS had been bitten in the face by little boy J in the building corner. I immediately said that from what I knew about the way DS and J interact, he must have had his share in the escalation and jumped at the chance to ask whether they had noticed these behaviors recently (not breathing a word about suspected AD(H)D or anything...). Yes, they had, but she was quick to add, that these behaviours showed only during free play or transitions, that he did fine during structured activities and that in fact he had participated wonderfully during some Road-to-Bethlehem activity the very day.</p>
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<p>I got the story out of DS afterwards: apparently J had knocked over some of his stuff, so DS built a volcano with a magma cap which erupted and took down J's buildings, the volcano itself getting destroyed in the event. <span><img alt="lol.gif" height="31" src="http://files.mothering.com/images/smilies/lol.gif" width="15"></span>.</p>
<p>Sorry. Ahem.<span><img alt="nono.gif" height="19" src="http://files.mothering.com/images/smilies/nono.gif" width="22"></span></p>
<p>I gather blocks were flying through the air, at least one hitting poor little J in the face, at which he must have lost it. The teachers only saw the bite and apparently were all over poor little J and his poor mum too  - which is understandable and right as it was a bad bite and that's really a total nono but i took care to let them know about the buildup, too. Which begs the question where were the teachers during the buildup? Out of the room pickjng up the Road-to-Bethlehem activity, that's where!</p>
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<p>So transition/free play/need to manage difficult social interaction after some structured activity that was interesting and challenging = kazoom!</p>
<p>I'll have to think about those patterns a bit more...</p>
 

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<p>ADHD:  ADHD is co-morbid with a whole bunch of stuff - in fact, a lot of kids have two diagnoses - ADHD and ___ or ___ and ADHD.  It's a totally subjective diagnostic protocol and I really have come to believe that ADHD-type behaviours are manifestations of other issues in many cases.  I just wouldn't sweat ADHD at 4 with a probably gifted kid who is manifesting sensory issues.  Deal with gifted and deal with sensory and I bet the ADHD stuff wanes.  Or it doesn't, and you deal with it when you're closer to the diagnostic age range.  Also, reference Dabrowski's psychomotor OEs.   I'm not being cavalier about it, but I've been really firm all along that DS doesn't have ADHD and at this point the school and professionals are going along that path - he's gifted, high OEs, sensory issues, vision issues.  Have you had his eyes checked by a developmental optometrist - the behavioural manifestations of strabismus are almost identical to those of ADHD.</p>
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<p>Testing:  We tested DS 5.25 and again at 8.  The testing at 8 was a better process.  I mention this to suggest that you may have to do it more than once.</p>
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<p>Sensitive self-awareness:  DS is painfully intuitive, insightful and self-aware.  That's made some stuff tougher, but it helped a lot with OT because he could understand where things were going.  We did only a short stint in OT, but the two evals were extremely useful.</p>
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<p>I would highly, highly recommend getting this book if you can (preview included here):</p>
<p><span style="text-decoration:underline;">Smart But Scattered</span></p>
<p><a href="http://books.google.com/books?id=J5MA8e5YHmQC&printsec=frontcover&dq=smart+but+scattered&hl=en&ei=ZLz5TNG-JoSasAOwmrT5Bw&sa=X&oi=book_result&ct=result&resnum=1&ved=0CCYQ6AEwAA#v=onepage&q&f=false" target="_blank">http://books.google.com/books?id=J5MA8e5YHmQC&printsec=frontcover&dq=smart+but+scattered&hl=en&ei=ZLz5TNG-JoSasAOwmrT5Bw&sa=X&oi=book_result&ct=result&resnum=1&ved=0CCYQ6AEwAA#v=onepage&q&f=false</a></p>
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<p>Self-regulation is an executive function issue, and kids with sensory issues struggle even more with it.  I found a lot of strategies to employ by researching sensory issues, giftedness and executive function.</p>
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<p>Your DS may be getting "worse" because he's developing - he's more complicated inside, and his perceptions of the world around him are becoming more complex.  My DS is like radar, picking up all this stuff around him, and at the same time his intrapersonal is also really multi-layered.  It's pretty overwhelming sometimes and as he gets older he develops and integrates more approaches to process it all.</p>
 

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<p>Ah, Smart but Scattered has actually been on my amazon list for a while - for understanding more about myself! It hadn't occurred to me I might need it for DS so soon. Thank you for reminding me.</p>
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<p>Well, we tried exercise in the snow and it totally backfired, physical tiredness making things a lot worse. He didn't calm down for ages at night and was mre or less awake from 2 am. I was a wreck all day...I also tried out more of the physical calming techniques today when he lost it several times over the excitement of having his favorite uncle with girlfriend visiting. Didn't work. What worked several times: sitting down for an interesting activity (eg playing with an electronic learning toy or designing and drawing an electrical nutcracker), both with an adult's attention. So today I'd have been ready to say it's just boredom and being spoiled for attention like DH said at first when I tried to get him on board for an eval, if there wasn't the other stuff. DH agreed that the mouthing, kissing, squeezing, bumping, hair yanking/grabbing/chewing that he does to other kids and to me appears compulsive, does not change with disapproval or redirection and may get him in serious trouble soon. He also remembered having impulses like this himself, and having a sister who chewed up bedclothes.</p>
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<p>He also kept reminding me that he's just four! I think the fact that it seems to be getting worse makes me lose sight of what's age appropriate sometimes. It was only late spring when we were complimented at a wedding for having the best-behaved child during the service! Just giving him drawing mateials and telling him to whisper was enough...</p>
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<p>Your DS may be getting "worse" because he's developing - he's more complicated inside, and his perceptions of the world around him are becoming more complex.  My DS is like radar, picking up all this stuff around him, and at the same time his intrapersonal is also really multi-layered.  It's pretty overwhelming sometimes and as he gets older he develops and integrates more approaches to process it all.<span style="display:none;"> </span></p>
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<p> Ah, this helps, too.</p>
 

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<p>I can't type under the quote for some reason.  But <strong><em>yes</em></strong> to this!  ADHD seems to be a catch-all diagnosis when behaviors are different from typical.  It's not that true ADHD doesn't exist; it's just that probably many of the kids out there with the label actually have a different root to their problems.  Furthermore, SPD seems to really overlap a lot of disorders, so working with that and the giftedness first is a really good approach.</p>
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<div class="quote-block">Originally Posted by <strong>joensally</strong> <a href="/community/forum/thread/1282753/sorry-long-we-appear-to-be-about-to-enter-the-bermuda-triangle-of-giftedness-spd-and-ad-h-d#post_16091809"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border-bottom:0px solid;border-left:0px solid;border-top:0px solid;border-right:0px solid;"></a><br><br><p>ADHD:  ADHD is co-morbid with a whole bunch of stuff - in fact, a lot of kids have two diagnoses - ADHD and ___ or ___ and ADHD.  It's a totally subjective diagnostic protocol and I really have come to believe that ADHD-type behaviours are manifestations of other issues in many cases.  I just wouldn't sweat ADHD at 4 with a probably gifted kid who is manifesting sensory issues.  Deal with gifted and deal with sensory and I bet the ADHD stuff wanes.  Or it doesn't, and you deal with it when you're closer to the diagnostic age range.  Also, reference Dabrowski's psychomotor OEs.   I'm not being cavalier about it, but I've been really firm all along that DS doesn't have ADHD and at this point the school and professionals are going along that path - he's gifted, high OEs, sensory issues, vision issues.  Have you had his eyes checked by a developmental optometrist - the behavioural manifestations of strabismus are almost identical to those of ADHD.</p>
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<p>Just another thought.....you said it was recent ramp up in behaviors.</p>
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<p>Is he growing?? I always see an increase in sensory behaviors from my DD w/ SPD when she is going through a growth spurt (usually lasts 2-3 weeks or so, sometimes more or less).</p>
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<p>Keep an eye on it and see if it settles down.</p>
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<p>We also see 'more' intensity with changes in routine (visitors, unexpected trips, events, etc).</p>
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<p>Physical affection is common in ages 2-5(touching, hugging, etc). As his teachers if it seems excessive at school....that will be where it will first be an 'issue' with other kids. If you are simply seeing more at home/outside of school ---it could be a result of 'holding it together' at school and coming home and unable to contain it anymore (or losing the ability to control impulses).</p>
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<p>Some is age appropriate to a degree. I work with 3/4s and there is a lot of touching, petting, hugging, etc in that crowd. Some kids more so than others......the intensity and frequency is what they will look at for SPD and ADHD. Since most people display ADHD/SPD behaviors at times, but only to a small degree.</p>
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<p>The 'chewing' is more SPD than ADHD---an oral motor craving. At some point you could try gum (if that is OK on your radar), our OT suggested that and really gummy foods that DD had to chew. That helped keep her from chewing on her fingers/clothes/etc. They have 'chewlery' that is necklaces/bracelets, etc that can be safely chewed and will help alleviate chewing 'non-chewable' items. We have also used on w/ DD and it was helpful. Her chewing needs were sensory based.</p>
 
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