Eval results... not sure where to go from here?

[Mrs.Mom]

Hi there! I have been following this forum for quite awhile, and doing a lot of research - waiting, waiting for our test results for my son.

 

My 11yo DS is incredibly bright. His abstract comprehension is off the charts, but school work is below where he should be. Conceptually, he is in the high school level. Writing and math skills are below. As in, can barely write a sentence - can't retain math facts. Yet, can write incredibly well thought-out stories/reports (typed) and can solve algebraic equations, right? I have read about stealth dyslexia, dysgraphia, working memory, processing speeds, etc. He has anxiety and ADD (the H is questionable. He is HIGH energy, but not impulsive...).

I decided to take him in to be evaluated because something is missing. He is too smart and too mature to have the output he does in school work. He could not succeed in a classroom right now and he knows it. It's beginning to crush his self-esteem.

The test had to be split into 3 sessions because after the first one, he zoned out. The NP stopped testing because it's like his brain hit his max. I think it was a blood sugar thing. She said it looked like a seizure. Weird, huh? I have seen this at home, but would not say blood sugar. It's more like....... a brain shut down and it impacts him physically. It's really hard to describe. But I was glad to have a witness!

After waiting and waiting, we finally had the results yesterday. She says anxiety is off the charts - even higher than I realized. She doesn't want to label him with panic disorder, but it's right up there. She said she is diagnosing general anxiety with panic symptoms. And of course, attention issues. She said they are so intertwined, it's hard to untangle them and tell what is doing what.

 

His working memory is fine, she said - which shocked me. I'm glad though! But she said his processing speed is slow. As in, low low... almost to the point if impaired.

I am not sure what to make of that. If his anxiety and ADD is so severe it's clouding his ability to think... that would make sense on the processing speed, right?

When this child takes a Ritalin (he was prescribed in the past), it is night and day. He can think. He can retain. He can remember the next day! He can work through problem solving and it's like he is able to work to his potential. I don't know how to describe it.

Do you think his processing speed is seriously that slow... or is that just in testing? With his anxiety and ADD in full bloom?

His IQ showed in the normal range, which again, is incredibly surprising to me. The kid started talking at 4 mths and taught himself to sight read at 2... real reading at 3. I'm just not sure what to make of it.

Oh, they also want him to get an OT eval. He was late, late in learning to tie his shows. He has a hard time forming letters and writing anything in general. It's like torture and causes a seizure-like quiver of frustration and angst. Anxiety and frustration. It's getting better as he matures, but she wonders if there are some fine motor skill issues.

My husband is supportive but not very nurturing, and not terribly "emotional" about my son (stepdad)... so I'm feeling a little isolated processing through all this information. My husband is a huge source of anxiety for my son - yet in other areas, his anxiety seems to be improving so much? I am so perplexed with all of this....

Thanks, all! I would love to hear your insight. I am so new to this - having answers stuff. He has been such an amazing and frustrating child to raise and teach. :)

[Ottakee]

Just a few quick thoughts.  It might be worth seeing a peds neurologist to rule out seizures as those can certainly cause some of the issues you are seeing.  My dd will lose years worth of skills after a seizures and it can take her hours to days to weeks to regain them.

 

You mention he is much different on the Ritalin and able to do his work.  Does he take it regularly?  If not, why?  Does he have a negative reaction to it?

 

After seeing the neurologist it might be worth seeking out a peds psychiatrist to help figure out the ADHD, anxiety, etc. stuff.  In the meantime a full physical with complete blood work would be a good thing to have---to check blood sugars, thyroid, anemia, and a host of other things that might be playing a role in this.  Even if it is all clear, you then have a baseline to work from if you do decide to try medications.

 

Counseling might also be helpful while or after you figure out what is going on  with the ADD, anxiety, etc.

[Mrs.Mom]

Thank you, Ottakee. I will follow your suggestions!

 

The reason he is off of the Ritalin is he was diagnosed by me and his pediatrician with basic questionaire and behavior that I observed in homeschooling/home life. I knew he had anxiety, also. Now that he is in 6th grade, the academics seem to really be worsening instead of improving, and I was concerned. I wanted to find out, officially through an eval, what was going on.

 

So we went off the Ritalin to get a more "raw" look, if that makes sense. I'm certain his eval would have been very different with the Ritalin. ;)

[Mrs.Mom]

PS - Can you tell me more about your child's seizures? I have no experience with this... any research jumping off points that I should be exploring?

[Incognito]

For the IQ results, you should look at the various subtests and also make sure that you are also looking at a GAI and NOT a FSIQ - with really low processing speeds that would pull down the score whereas GAI is about the ability, not speed.

 

FWIW, I have a kid who hit the ceiling in some subtests and scored middle low in some others.  It comes out looking more average, but really isn't (and that was noted and emphasized by the tester).

 

If you ever find out what that blank stare off to space is please let me know - we have the same thing, but it is too periodic for it to be witnessed by anyone.

 

 

[PeterPan]

 

Do you think his processing speed is seriously that slow... or is that just in testing? With his anxiety and ADD in full bloom?

...

My husband is supportive but not very nurturing, and not terribly "emotional" about my son (stepdad)... so I'm feeling a little isolated processing through all this information. My husband is a huge source of anxiety for my son...

Yes, his speed is that low.  When we got my dd's, well let's just say there was a whole lot a repenting and some changes made...  Just accept it.  The meds do bump processing speed btw, so if he's normally on them that might explain for you the discrepancies.

 

On your dh, I'm trying to be polite here, but how is your dh creating so much anxiety for your ds?  Can you get some counseling to change whatever is going on?  

 

Well sounds like you got your confirmation on the need for the meds, which you wanted.  Is the psych steering you to counseling or CBT or something for the anxiety?  

 

And yes, if the psych is suggesting an OT eval you ought to get one.  I got my dd her OT eval at 11, and we learned a TON on why she felt the way she did, what things were aggravating her, and how to help her be in a better place.

[Ottakee]

A psychiatrist might give you more assurance with the meds and also help address the anxiety.

 

If he has done well on the meds though the testing certainly seems to advocate their use.

 

Do you see the staring spells while on the Ritalin?

 

For the seizures, google petit mal seizures or complex partial seizures.  The petit mall, esp. can be easy to miss or mistaken for daydreaming, etc.  The best thing is to see a neurologist and get an EEG done.

[SandyKC]

The test had to be split into 3 sessions because after the first one, he zoned out. The NP stopped testing because it's like his brain hit his max. I think it was a blood sugar thing. She said it looked like a seizure. Weird, huh? I have seen this at home, but would not say blood sugar. It's more like....... a brain shut down and it impacts him physically. It's really hard to describe. But I was glad to have a witness!

After waiting and waiting, we finally had the results yesterday. She says anxiety is off the charts - even higher than I realized. She doesn't want to label him with panic disorder, but it's right up there. She said she is diagnosing general anxiety with panic symptoms. And of course, attention issues. She said they are so intertwined, it's hard to untangle them and tell what is doing what.

 

His working memory is fine, she said - which shocked me. I'm glad though! But she said his processing speed is slow. As in, low low... almost to the point if impaired.

 

I am not sure what to make of that. If his anxiety and ADD is so severe it's clouding his ability to think... that would make sense on the processing speed, right?

 

Do you think his processing speed is seriously that slow... or is that just in testing? With his anxiety and ADD in full bloom?

 

His IQ showed in the normal range, which again, is incredibly surprising to me. The kid started talking at 4 mths and taught himself to sight read at 2... real reading at 3. I'm just not sure what to make of it.

 

Oh, they also want him to get an OT eval. He was late, late in learning to tie his shows. He has a hard time forming letters and writing anything in general. It's like torture and causes a seizure-like quiver of frustration and angst. Anxiety and frustration. It's getting better as he matures, but she wonders if there are some fine motor skill issues.

 

My husband is supportive but not very nurturing, and not terribly "emotional" about my son (stepdad)... so I'm feeling a little isolated processing through all this information. My husband is a huge source of anxiety for my son - yet in other areas, his anxiety seems to be improving so much? I am so perplexed with all of this....

 

Thanks, all! I would love to hear your insight. I am so new to this - having answers stuff. He has been such an amazing and frustrating child to raise and teach. :)

On what "looks like a seizure," and the quivering with writing, I'd highly suggest a neurological workup for absence seizures, other types of seizures, and to determine if there are neurological impulses that are causing his body to "lock up."  Absence seizures can have a significant effect on learning.

 

Processing speed is separate and a child's processing is generally fast or slow and that is not affected by ADD or directly by memory, particularly if working memory is fine. So, yes, processing speed probably is seriously that slow. 

 

Keep in mind, his IQ being in the "normal" range is a composite of the subtests that measure intellectual functioning.  You don't say what his subtest scores are, but if a child scores at 145 on one subtest and 65 on another and then 100 on the other two measures, then his composite IQ will be "average." However, THAT is NOT an accurate reflection of the child's intellectual capability.  Typically the memory and processing speed indexes reflect cognitive "efficiency." The Verbal Comprehension and Perceptual Reasoning indices are more of a measure of a child's direct learning.  They are all factors in a child's ability to learn and use the knowledge, but the highest of the verbal and perceptual measure is most often the best indicator of a child's learning ability--particularly when learning deficits are remediated and assistive technology to circumvent learning deficits.

 

For any child with a very high IQ who is highly frustrated by extremely low areas of functioning, the level of anxiety and frustration can become an issue because the child is intelligent enough to **KNOW** something isn't right.  Getting counseling is often a godsend if you can get a really could provider who understands twice exceptional (Gifted with LD) kids.  2E kids can have their own unique set of anxieties and insecurities. ;-)

[Mrs.Mom]

Thank you! I'll re-read the comments in the morning and research some more. They are mailing the report and scores, so I can post those when I get them.

[Mom22ns]

The test had to be split into 3 sessions because after the first one, he zoned out. The NP stopped testing because it's like his brain hit his max. I think it was a blood sugar thing. She said it looked like a seizure. Weird, huh? I have seen this at home, but would not say blood sugar. It's more like....... a brain shut down and it impacts him physically. It's really hard to describe. But I was glad to have a witness!

My son had absence seizures when he was young. He just locked up... disappeared. They showed up on an EEG as complex partial seizures. I would talk to your pediatrician and get an referral to a pediatric neurologist to get this checked out. 

Do you think his processing speed is seriously that slow... or is that just in testing? With his anxiety and ADD in full bloom?

I'm going to agree with OhE here. Yes, it probably really is that slow. 

 

His IQ showed in the normal range, which again, is incredibly surprising to me. The kid started talking at 4 mths and taught himself to sight read at 2... real reading at 3. I'm just not sure what to make of it.

IQ tests are not at all accurate for kids with multiple issues. Their highs can max out the test and their lows... well, lets just say it doesn't create a real picture. Ds, whose latest IQ test put him in the 99.5th percentile I believe, had his first IQ test in an early childhood special ed program show his IQ as average. This from a child who started reading at 2.5. I didn't buy it either. Don't. Know that his highs are being masked by his lows. 5 or 10 years from now, testing will probably show very different results.

 

Oh, they also want him to get an OT eval. He was late, late in learning to tie his shows. He has a hard time forming letters and writing anything in general. It's like torture and causes a seizure-like quiver of frustration and angst. Anxiety and frustration. It's getting better as he matures, but she wonders if there are some fine motor skill issues.

An OT eval is a great idea. There could be multiple reasons for that quiver. Checking for fine motor issues, possible dysgraphia, sensory issues... an OT will do no harm and may be a treasure.

 

Raising kids with disabilities of any type is amazing and frustrating. Your child sounds like many 2e kids, which he may or may not be. He may be normally bright with issues, or he may be exceptionally bright with issues. Neither one keeps him from being a amazing, lovable child. Enjoy him. Celebrate his victories - even the little ones - because they are hard won. Work with him to overcome or learn to work around his challenges. Be patient. Remember this is going to take a lifetime, but that is exactly how long you have. And whatever you do, don't compare him to anyone else. He is different, but different isn't bad, it is just different. Comparisons with our kids always hurt. They hurt us, they hurt our kids, and they can even hurt the relationships with those that are being held up for comparison. Just don't go there. Ok, you will, but pull back every time :). 

 

When you need support, come here. You can always know there will be others that have felt the same things. For me the hardest part about raising an ASD child was feeling isolated (I know your ds isn't ASD, that is just where I was). 15 years ago, I didn't have these boards. Make sure you find support, hopefully from dh, your family, friends, maybe a group near you, but in the very least find cyber support!

 

eta: sorry, my text color in my responses didn't show up initially. Hopefully it is easier to read now.

[kbutton]

I am just agreeing with others and chiming in that processing can be very low even in an otherwise very bright child. My kiddo has super low processing speed. It shows up all over the place.