So, my DH was recently dx with ADHD-Inattentive - Update #19

[SarahW]

I wasn't sure what board to put this on...

 

My DH went to a psych (finally!) for ongoing depression/anxiety/insomnia/etc. and ended up with an ADHD-Inattentive diagnosis. Oh. Yeah, that explains a lot.

 

I've been trying to find out more about what this means, and along the way read that ADHD can run in families. My DH has commented more than once that our eldest is "just like me when I was his age" (which causes my MIL to sigh deeply in despair, lol), and now I'm wondering if all the issues he had in his kindergarten classroom which led us to homeschool him was because of ADHD.

 

I had the school give him a screening test for the gifted program, and I posted the results. Funny, now that I read that thread again, that I mentioned that he would "check out." Spaciness, not following directions, losing things, fatigue, etc. were all things commonly talked about in parent-teacher conferences that year. He's not particularly hyper, especially not in social settings where he's rather subdued (I believe he's introverted) and doesn't fidget a lot except for having a need to chew and mouth objects (his pencils! oy!!!). And he's only occasionally impulsive, and my DH has been working with him that the first (and second) rule of life is "Don't do stupid stuff!" and that seems to help him think before he acts. So Crazypants is mostly just the quiet, dreamy sort, the same things which got my DH labeled as "lazy" and sent to an alternative school for "dumb" kids.

 

I've been trying to figure this kid out. So I got preliminary intelligence test scores which put him as high abstract reasoning, but poor verbal skills (still don't think that that's entirely accurate). He fits all the criteria for VSL. And there's possible ADHD-Inattentive. So bright, visual, and hears voices (jk, he says that his "brain tells me stuff" and that's why he doesn't listen very well).

 

Now that he's back in school in NL, the kindergarten misbehavior is beginning again. He's also underachieving. He told the teachers that he only knew "a little" multiplication and "division, what's that?" so that he only had to do addition and subtraction in math. And he's reading the same simple book over and over in reading time. The teachers weren't fooled very long, and came to my DH to ask, "You do realize he's very advanced in math?" Dh told them he knew, they do BA after school every day (I think they're mostly through 3C right now), but even though Crazypants knows that everyone knows he's better at math (he's using the language barrier to hide the reading), he still insists on only doing easy stuff.

 

We'll be back to homeschooling in a few months. Crazypants is excited to homeschool again, he heavily lobbied to move to a country where it's legal. I can see how homeschooling is best for him, I would let him jump around during oral lessons, chew his pencil, and do some work on the computer. But I'm struggling to think how to adapt to his needs and also scaffold the skills and EF he lacks because of (very probable) ADHD-Inattentive.

 

For example, he enjoys BA and enjoys learning new math concepts, but his math facts are abysmal. I've tried showing him patterns, playing multiplication songs, doing multiplication bingo, doing rote drill, I'm out of ideas. (My DH also very likely has dyscalculia, so he has no idea either). Practice problems take forever because of "oh, wait, what was I doing? what is this? I forget where I was...seven times three is - look, I found my red crayon!" over and over.

 

Another example, he likes to discuss grand metaphysical ideas with DH, but when it comes to basic reading comp questions he's totally lost. He reads fine, but it's like the words just glide right through his brain and out the ears. I read it out loud to him, and the words still fall out his ears. I read the question and then the sentence with the answer in it, and he goes "huh?"

 

:svengo:  :svengo:  :svengo:

 

idk...... help?

[SarahW]

Wait, so I just googled for more info on the KBIT-2, and came across this research that kids with ADHD score lower on the verbal section of the KBIT-2 than the WASI.

 

If he does have ADHD, maybe that explains his low verbal score. Maybe.

 

:confused:

[PeterPan]

This will make your head swirl, but here is KBIT correlated to the WISC.  http://alpha.fdu.edu/psychology/kbitwisc.htm

 

He sounds very bright, and yes he's probably ADHD-inattentive.   :)  If he's still mouthing objects, time to get him an OT eval, if you have access to OT for sensory where you are.  Find someone who deals with a lot of ASD, and they can handle it.  ADHD and ASD overlap as far as sensory, so that's why you're going to look that direction.  

 

Do you have access to someone who speaks his native language who can do a full psych eval on him?  When you're ready, it will probably give you good info on how to teach him.  Sometimes they'll turn out to have processing speed or working memory issues or need some referrals.

 

At this point, aside from the obvious stuff (working with him better, rolling with him), the thing you want to read about is executive function (EF).  The more you work on that and support that, the better.

 

PS.  Yes, you're in the right place.  Welcome to LC.  :)

[ashamama]

Your post reminds me of us a bit. My DH was dx'd ADHD in high school. When ODS was 4 I realized despite being really smart, some things weren't there. He has sensory issues (SPD) and also the ADHD which often go together. He also has a convergence insufficiency and it's lead to a wealth of other symptoms. He is kindergarten. Age right now working mostly on a 2ed/3rd grade level for his subjects. DH and I both tested highly gifted in school and I want to test ODS to though am not sure how since he is not in school. He is very bright, but he can't sit still for anything. And he chews everything (we have several types of chewelery/chew stixx/etc). He likes his subjects to go quickly. We do Classical Conversations and he loves how quickly they progress through the memory work. We try at home to move right through our subjects because he doesn't like them to take too long. We use several adaptations like a weighted vest and thera bands tied to the legs of his chairs. Honestly, pinterest is great for finding these things! We also have the book Sitting Still like a Frog to help work on his mindfulness and attention. And we load up on omega 3s and DHA. Nordic Cod Liver Oil is the best one we found. It improves his attention immensensely! Also if he likes to chew, try doing reading at a time when he is eating or has just eaten something crunchy (celery/pretzels) etc. And do a quick movement thing beforehand to wake up the brain and senses. But I find That my boy retains best when doing more than one thing at once. The crunchy food is enough sensory input that his mind doesn't wander and he stays focused on task. How is his sleeping? If he has a million though in his mind, sleeping can be tricky. Mine had trouble sleeping before we started mindfulness and the Rabbit Who Wants to Fall Asleep. Poor sleep meant poor retention.

[kbutton]

Smart But Scattered

The Mislabeled Child

 

Good books that might help you sort more out. Welcome!

 

You might find some good books on ADHD in marriage--they all seem to have an equal split with some people reviewing them as biased against the ADHD spouse and others biased toward the ADHD spouse, but you might find some insightful. Or maybe just some books on adult ADHD. Again, the reviews are very mixed. I hope your husband finds the dx a relief and a beneficial starting point.

[ashamama]

Also Empower ADHD kids has lots of good strategies in it.

[Citrusheights5]

For adult ADD PBS had a show called ADD and loving it. Great show about adult ADD, it also had a follow up but I can't remember what it's called, but it you do a search a 30 minute clip will pop up, on you tube.

 

Reason I point it out,is that is gave me some great ideas about in adulthood what specifically are going to be problems, and what are some good "band-aids" and coping skills to help bridge certain gaps.

[1shortmomto4]

I don't have anything to add in the ADHD department - I'm learning how to deal with that currently with an much older child but I do know about VSL as my youngest is VSL.  They are very bright and it takes a lot of patience, creativity and always be prepared ahead of time to change things up.  A VSL kiddo does not enjoy nor do they really achieve much with drilling of facts or really the expectations of having the math all memorized.  They can do those advanced math concepts but simple multiplication is s  l  o  w.  Key to remember is once they under a lesson there is no need to go back and redo, review or reteach (unless you have dyslexia).  You need to teach in mastery units.  They get overwhelmed on a subject and you have to step back, do something else for a bit (this is where books about math or Life of Fred work well) while their brains process the information.

 

As for reading and comprehension - that does take time because VSL tends to be a late bloomer in the reading department.  Oh, they can read the words and need very little instruction in spelling (again, once taught no need to cover again) but comprehension takes some time.  My ds is now 12 but I wasn't seeing true comprehension until late 10 to 11. A few things to try to see if comprehension improves - have your child playing something like building legos or coloring a page (SOTW has those coloring pages) and see if you don't get better results with comprehension.  Another option is to try a graphic (cartoon) book and see if there is better retention.  A book from the "So You Wouldn't Want To Be" series (TinTin is probably too hard yet) might produce some results.  I truly understand the voices as my ds is always talking whether anyone is around or not.  It is rather interesting to hear their stories about "discussions" they've had with a visiting bird or a spider - try to get him to put it out on paper or scribe for him.

 

Do you make a big deal about the pencil chewing?  Does the teacher?  My oldest used to want to sharpen his pencil constantly (this happened way back when after I brought him home to school him).  He'd get up and want to sharpen - especially when a subject being worked on was a challenge.  I found myself constantly frustrated with it and pointing it out and responding in a negative way.  Once I conciously decided not to mention it and just busy myself elsewhere so he couldn't read my face for reaction (my ds is hearing impaired) that learned coping behavior disappeared.  I wonder if replacing the pencil with a squishy ball might help?  Going on the basis that the chewing is a result of stress.  (Again, no expert here).

 

Just a few rambling early morning thoughts.

[SarahW]

This will make your head swirl, but here is KBIT correlated to the WISC.  http://alpha.fdu.edu/psychology/kbitwisc.htm

 

He sounds very bright, and yes he's probably ADHD-inattentive.   :)  If he's still mouthing objects, time to get him an OT eval, if you have access to OT for sensory where you are.  Find someone who deals with a lot of ASD, and they can handle it.  ADHD and ASD overlap as far as sensory, so that's why you're going to look that direction.  

 

Do you have access to someone who speaks his native language who can do a full psych eval on him?  When you're ready, it will probably give you good info on how to teach him.  Sometimes they'll turn out to have processing speed or working memory issues or need some referrals.

 

At this point, aside from the obvious stuff (working with him better, rolling with him), the thing you want to read about is executive function (EF).  The more you work on that and support that, the better.

 

PS.  Yes, you're in the right place.  Welcome to LC.   :)

 

 

At this point, I'm sorta hating the KBIT - what's the point of knowing numbers if they might not be accurate? How inaccurate are they? What does it mean? Being confused is worse than being in the dark, I think.....

 

Tell me more about sensory and OT....you can explain things like I'm an idiot, because I think I am here. The concept has me just scratching my head. He's not overly physically sensitive to clothing or anything, he just asks for chew toys. He once stole the baby's pacifier to chew on (baby never took to pacifiers, so whatever). I find it simply bizarre, and I'm not sure what to do about it.

 

I've asked DH if he's thought about getting our son tested, but he didn't seem to find it urgent. He's still coming to terms with his own dx, I suppose. There's a 70% chance that we'll be living in the UK in November, so I'm thinking to wait on getting evals done until we get there. Am I looking for a full IQ test? A psych who is familiar with ADHD and/or ASD, and maybe giftedness?

 

EF, yes, yes, yes. My DH is starting to work on that. I think I'm a pretty patient person, but I find this challenging. I chafe at schedules and to-do lists, why do all that work when you can just do life? But the people I live with don't work like that, sigh.... I've read most of the recommended EF books, but I didn't really understand them. I'll have to read them again, remembering that they're not for me.

[SarahW]

Your post reminds me of us a bit. My DH was dx'd ADHD in high school. When ODS was 4 I realized despite being really smart, some things weren't there. He has sensory issues (SPD) and also the ADHD which often go together. He also has a convergence insufficiency and it's lead to a wealth of other symptoms. He is kindergarten. Age right now working mostly on a 2ed/3rd grade level for his subjects. DH and I both tested highly gifted in school and I want to test ODS to though am not sure how since he is not in school. He is very bright, but he can't sit still for anything. And he chews everything (we have several types of chewelery/chew stixx/etc). He likes his subjects to go quickly. We do Classical Conversations and he loves how quickly they progress through the memory work. We try at home to move right through our subjects because he doesn't like them to take too long. We use several adaptations like a weighted vest and thera bands tied to the legs of his chairs. Honestly, pinterest is great for finding these things! We also have the book Sitting Still like a Frog to help work on his mindfulness and attention. And we load up on omega 3s and DHA. Nordic Cod Liver Oil is the best one we found. It improves his attention immensensely! Also if he likes to chew, try doing reading at a time when he is eating or has just eaten something crunchy (celery/pretzels) etc. And do a quick movement thing beforehand to wake up the brain and senses. But I find That my boy retains best when doing more than one thing at once. The crunchy food is enough sensory input that his mind doesn't wander and he stays focused on task. How is his sleeping? If he has a million though in his mind, sleeping can be tricky. Mine had trouble sleeping before we started mindfulness and the Rabbit Who Wants to Fall Asleep. Poor sleep meant poor retention.

 

I'll look up the things you mentioned. He definitely has issues with the "living books" approach - why take so long to just get to the point? My DH read encyclopedias as a kid, and Crazypants seems to enjoy that format as well (he recently read the whole UEWH and said it was "really interesting"). I try to keep our schoolwork efficient and to the point, and mask my disappointment that our homeschool doesn't look more CM sitting on the couch reading lots of pretty books. 

 

Sleeping, yes! We put him to bed, and he stays awake talking about all the things his brain tells him, asking metaphysical questions, and complaining that his brain won't let him sleep. He often won't fall asleep until late (10 or 11 pm) which is bad for getting up early to go to school, and yes, he just needs more sleep.

 

Just had a thought, he likes to eat salad greens, maybe I could put a bowl full of baby greens next to him during math and seatwork.

[SarahW]

Smart But Scattered

The Mislabeled Child

 

Good books that might help you sort more out. Welcome!

 

You might find some good books on ADHD in marriage--they all seem to have an equal split with some people reviewing them as biased against the ADHD spouse and others biased toward the ADHD spouse, but you might find some insightful. Or maybe just some books on adult ADHD. Again, the reviews are very mixed. I hope your husband finds the dx a relief and a beneficial starting point.

 

 

My DH talked to the psych about marriage, ADHD, and me. The psych told him that he was very lucky to have such a wonderful wife! So I'm basking in appreciation right now, lol. I try not to be overly-critical (or mean) when I point out his EF faults, but on the other hand, my DH doesn't understand anything I tell him unless it is very direct and clear. So....I'm still finding the nice but effective spot.

 

I'm perusing the library ADHD section. Some of the books have me scratching my head. Hopefully, I'll get clarity here at some point!

[SarahW]

I don't have anything to add in the ADHD department - I'm learning how to deal with that currently with an much older child but I do know about VSL as my youngest is VSL.  They are very bright and it takes a lot of patience, creativity and always be prepared ahead of time to change things up.  A VSL kiddo does not enjoy nor do they really achieve much with drilling of facts or really the expectations of having the math all memorized.  They can do those advanced math concepts but simple multiplication is s  l  o  w.  Key to remember is once they under a lesson there is no need to go back and redo, review or reteach (unless you have dyslexia).  You need to teach in mastery units.  They get overwhelmed on a subject and you have to step back, do something else for a bit (this is where books about math or Life of Fred work well) while their brains process the information.

 

As for reading and comprehension - that does take time because VSL tends to be a late bloomer in the reading department.  Oh, they can read the words and need very little instruction in spelling (again, once taught no need to cover again) but comprehension takes some time.  My ds is now 12 but I wasn't seeing true comprehension until late 10 to 11. A few things to try to see if comprehension improves - have your child playing something like building legos or coloring a page (SOTW has those coloring pages) and see if you don't get better results with comprehension.  Another option is to try a graphic (cartoon) book and see if there is better retention.  A book from the "So You Wouldn't Want To Be" series (TinTin is probably too hard yet) might produce some results.  I truly understand the voices as my ds is always talking whether anyone is around or not.  It is rather interesting to hear their stories about "discussions" they've had with a visiting bird or a spider - try to get him to put it out on paper or scribe for him.

 

Do you make a big deal about the pencil chewing?  Does the teacher?  My oldest used to want to sharpen his pencil constantly (this happened way back when after I brought him home to school him).  He'd get up and want to sharpen - especially when a subject being worked on was a challenge.  I found myself constantly frustrated with it and pointing it out and responding in a negative way.  Once I conciously decided not to mention it and just busy myself elsewhere so he couldn't read my face for reaction (my ds is hearing impaired) that learned coping behavior disappeared.  I wonder if replacing the pencil with a squishy ball might help?  Going on the basis that the chewing is a result of stress.  (Again, no expert here).

 

Just a few rambling early morning thoughts.

 

 

Rambles are fine.

 

With math, though he likes BA, he gets frustrated with the workbook sometimes because he doesn't have the math facts to puzzle through some of the questions. I have to lead him through, "well, 6x5 is 30, does that work here? No? How about 6x6? That's 36. Does that work? Yes? Ok...." His addition and subtraction facts have finally solidified, so maybe the rest will just come with time? We take breaks...he's reading Math for Smarty Pants, and he has a Penrose and math riddles book on is Kindle that he reads sometimes. It's frustrating for me, because I see that if he was more linear, he could be already working on more advanced concepts that he would enjoy. Oh well, he'll get there on his own time, I suppose.

 

He read nothing but GN's last year. I also had him do some non-GN reading as a part of schoolwork, but the GN did help him with fluency and comprehension. But now he's decided that "picture books" are for babies, and I'm scrambling to find his next genre. My DH has never read novels, except for Lord of the Rings and some Umberto Eco, so I'm preparing myself for the idea that Crazypants will never be a literature-loving bookworm. Nonetheless, I want him to eventually have the ability to read advanced literature. Maybe I need to keep some (short, sweet, and effective) reading "curriculum" in the homeschool plan?

 

We try not to yell at him too much for the chewing. The time he chewed through the cord for his computer headphones he got a stern talk. Chewing on pencils just annoys me. I got him thick mechanical pencils (so he didn't have to bother with sharpening) and he chewed the ends so bad they wouldn't click out more lead. He used to chew on his shirt, but DH told him to stop. I suppose I should find him something he can chew. But that's the pickle I'm in - how much do I work with his behavior, and how much do I try to correct it?

 

I mean, I know he's not normal, and will never be normal, so how much should I try to train him to act normal????

[kbutton]

My DH talked to the psych about marriage, ADHD, and me. The psych told him that he was very lucky to have such a wonderful wife! So I'm basking in appreciation right now, lol. I try not to be overly-critical (or mean) when I point out his EF faults, but on the other hand, my DH doesn't understand anything I tell him unless it is very direct and clear. So....I'm still finding the nice but effective spot.

 

I'm perusing the library ADHD section. Some of the books have me scratching my head. Hopefully, I'll get clarity here at some point!

 

Yeah. Just, yeah. It's hard to find that spot, and the onus might be on you to find it--the good news is that you might discover some areas where he has good EF. EF is definitely a set of skills, not all or nothing. If he happens to have self-awareness, then that will help a lot once he gets the general idea. If he doesn't, then you will have to figure it out, explain it to him, etc. 

 

I am very big picture, my DH is sequential. That is also a big thing with explanations. I use a lot of comparisons...if this such and such unfamiliar thing was a thus and so familiar thing...

 

As for the chewing with your DS, that could be your son's only sensory issue, or it could be that he has more, but you've not seen the "textbook" stuff (in that case, he would have other behaviors that you just haven't thought of as sensory). He may be using chewing to keep himself aroused enough to attend. If the chewing actually seems to distract him, that will require a different solution. He might also have something weird like sinus pressure that has nothing to do with any of this, or it could be a combination of things. You might have to offer something to chew on as mentioned above, but you will probably have to make a rule that those things are "tools, not toys." Some kids will play with one kind of tool, but use another appropriately even when they are similar. I do think an OT can help. Even if sensory isn't a big issue for him all around, an OT can introduce you to How Does My Engine Run, Zones of Regulation, or other therapies that can help you out.

 

We walk a wavy line here of strategies, training, re-training, more training, support, coping, and meds. :-) 

 

It's hard to make yourself be more organized in order to help the rest of the family who is less organized cope, but you can do it. I'm learning how to do so slowly. 

[PeterPan]

When he's chewing that much, he's having more sensory issues than you realize.  He needs the OT.

 

It's not about training him to act normal.  It's that a need met is a need that goes away.  His body is showing you he has a need, so you can either ignore it or help it.

[SarahW]

I'm researching the internet (dangerous, I know!) and came across this site. So, I'm looking at SPD of crave/seeking sensory input, particularly oral?

 

I'm trying to think of other sensory issues he has, and not coming up with anything in particular. Though the other day he was at the park with DH, and he decided to put his head down and run full speed at a wall. That may fall under impulsive "doing stupid stuff." Deliberately doing something physically dangerous is not a normal occurrence, though not realizing the result of his actions happens frequently enough to have the rule of "not doing stupid stuff" I suppose.

 

I'll talk to DH about getting him a chew toy and increasing his physical activity. And I'll look into OT in England.

[PeterPan]

Look for tests for retained reflexes.  It (the sensory stuff) is going to show up as sensory seeking, sensory avoiding, odd reactions, self-regulation (motor speed), etc.  They can do neurofeedback and get his brain to wind down better at night.  

[Storygirl]

Sometimes it's hard to tell just from reading a checklist. I knew my son had SPD from age two, so the idea was nothing new to me, but when he was evaluated again around age 9 or 10, it showed me a lot of things about DS that I had not noticed before. A professional evaluation will reveal a lot that you wouldn't figure out on your own. It's worth doing at some point, since you can see that he has some sensory needs.

 

 

[ashamama]

I'm researching the internet (dangerous, I know!) and came across this site. So, I'm looking at SPD of crave/seeking sensory input, particularly oral?

 

I'm trying to think of other sensory issues he has, and not coming up with anything in particular. Though the other day he was at the park with DH, and he decided to put his head down and run full speed at a wall. That may fall under impulsive "doing stupid stuff." Deliberately doing something physically dangerous is not a normal occurrence, though not realizing the result of his actions happens frequently enough to have the rule of "not doing stupid stuff" I suppose.

 

I'll talk to DH about getting him a chew toy and increasing his physical activity. And I'll look into OT in England.

There are check lists. Sometimes it is hard to tell. My boy is a mix of sensory seeking and avoiding. So he craves proprioception (pressure on the joints) and is constantly jumping, bearing weight on his arms and chewing. But he is a auditory defensive. He can't stand vacuums or loud noises like public toilets flushing. I didn't realize that normal crowd noises we too much for him until he was wearing his ear muffins that we got for loud places in a normally volume place and instead of darting around, spinning and jumping, he walked calmly by my side in straight lines. These are places like the grocery store where he never ear covered, but became "disorganized." So sometimes a kid can be seeking, avoiding and under responsive all at once. The good news about sensory behavior is you can satisfy the need by upping the craved sense and doing sensory integration. Before we do seat work we do several creative movement songs that involve spinning and skipping in a circle and falling down. After this his sensory needs are met and he can focus more easily. Then at night we have to wind down and put his thoughts "in a box" until morning and focus his attention on his body and breathing. Otherwise bedtime takes 3+ hours. Also kids with sensory challenges often feel out of control and seek to control their environments. Having visuals that he uses to keep track of his schedule are a must ft or my guy.

[SarahW]

Just an update...

 

I had DH talk to our son's teachers at school about the possibility of ADHD. They were very glad DH brought it up, as they were concerned and not sure how to bring it up. According to the one teacher, Crazypants has exhibited behavior in class that the teacher "had only previously seen in autistic children." The example he gave was that during the class activity where the students are expected to get up and sing with arm movements, Cp would run to the corner, go under a table, clap his hands over his ears, and squeeze his eyes shut. Cp also often sits out of group activities in PE.

 

Now, this avoidance behavior doesn't really surprise me. But I don't think autism is the right diagnosis. I've met kids with "classic" autism, and I don't see any of the typical behaviors in my son. Cp is social, makes eye contact, and has good communication skills. He is a bit shy, and likely a bit of an introvert, so in strange or new groups he does hang back. But when in the company of a few kids he knows, he's outgoing and perfectly normal. I've sort of thought his avoidance of situations to be because of introversion, but hiding in the corner during singing time is, yes, a bit more extreme. So probably not autism, but a part of SPD?

 

DH is trying to get him an appointment with a ped. neuropsych there. Not sure how long that will take. I've told my DH to make sure they check for ADHD and SPD, and not default to ASD, but we'll see. If your kid gets an diagnosis which you think is totally off, can you just ignore it?

 

Now that I have some possible idea of what is going on with my kid, I'm thinking about curriculum options. Most specifically, I'm wondering if I should bit the bullet and order the next levels of AAS. I started it because when Cp was in school for K "invented" spelling was encouraged, and he picked up bad habits. He did really well with AAS, so much that I thought it was overkill and that he was a "natural" speller. Now I'm wondering if it worked so well because it was such a good fit for him. He really liked moving the tiles around and knowing "the rules" for words (we never used the CD, and dropped the green cards early on). I think it's pricey just for spelling, but I'm thinking the cost is worth it here.

 

(Plus, I've noticed that my 2yo is a late talker, and will probably need additional language-development support, so I'll probably be needing to use the AAS for him eventually).

 

I've ordered the next level of BA for him (which makes him very excited), and he's still working on LfC (which I think he likes), but other than those things, I haven't made firm plans for the coming year (I'll be back to teaching him next month). My DH is starting the practice of taking hour long walks or bike rides with him, so we'll try to keep up the physical activity. And we'll keep exploring his "passion of the day" in history and science. But I'm not sure what else is necessary right now, or would be especially helpful. Any ideas?

[Tiramisu]

I have a mix of things going on here. Oldest with confirmed processing issues but supposedly no ADHD, and two have ADHD. All of us have sensory issues. My most normally behaving kids have also had the most sensory issues. Sometimes I think we could be on the mild side of the spectrum; other times no. It's hard to sort out when there are those different things going on and the symptoms are generally mild. Ped thinks we would never get an ASD dx. I like the term broader autistic phenotype that I first heard here.

 

When I've heard of people getting an unexpected ASD dx, it usually takes some time to sink in and for the parent to accept it. Generally, there can be skepticism at first, but as the parent learns more, they accept the dx more.

 

Social communication is tricky. It can seem fine and then you get a surprise. I was recently surprised when I realized one of my kids with seemingly great oral communication skills isn't getting figurative language in writing. Another child's oral communication skills are great but then I realized she seems to misinterpret body language and the motivations of others. I think I'm a great communicator but lately my kids have been correcting my faux pas, and prompting me to say certain things and not say others. I also did not do well on an online test of quickly reading facial expressions. There are a lot of contexts for communication and they become more complex with age. That's sometimes when weaknesses can become more apparent.

[kbutton]

If your kid gets an diagnosis which you think is totally off, can you just ignore it?

 

But I'm not sure what else is necessary right now, or would be especially helpful. Any ideas?

 

I would go with AAS--you are probably right that it seemed easy because it was a good fit. He also sounds very bright, and that means he's going to pick up quickly on most things and make it look easy. 

 

BTW, I giggle every time you call your son Crazypants. It's just cute. It says a lot about your sense of humor--apparently you roll with it pretty well.

 

About the diagnosis...yes, no, and maybe. The ADHD, SPD, ASD, smart kid interplay is not an easy one to decipher. You can have those things individual, in pairs, or all together. I thought we were going to get ADHD and maybe the SPD would get missed. I turned over additional rocks to be sure we knew what was going on...well, for us, it was all three. If I had been told this when my son was 8, I would have been upset and probably thought people were crazy (depending on how they approached it and explained it). When it was suggested at 9, I thought it was odd, and said all those things about eye contact, classic autism, etc. Almost like what you said. Then we went to homeschool convention, and a nationally known speaker described what gifted kids with autism often look like. My husband was in the session, but it was so crowded that we were not sitting together. As soon as we left the session and could talk in the hall, we said, "Are you thinking what I'm thinking?" We went back to the psych and asked for the testing. Not only that, two other kids a lot like my son came to mind for both of us, and in the intervening years, one of those families (the one that we keep in touch with), has been told that their son would probably qualify for an ASD diagnosis as well. In the years since then, it's become more and more obvious even though my son has matured, and we've worked on issues directly related to his ASD.

 

You might not be looking at a spectrum diagnosis, but you should take the suggestion seriously, let it marinate, and consider going down that path later. ASD labels open doors for therapies that you might wish you had taken advantage of later.

 

Our ASD bus may be better camouflaged than the standard yellow bus, but it's still an ASD bus. The wheels still fall off, and they still fall off for the same exact reasons. It's just that we can often keep the wheels on longer, or the potholes that knock the wheels off have to be much bigger. For instance, my son has difficulties categorizing things and then making a label for them. This is a typical skill for ASD kids to have trouble with. But for my son, he's not struggling with "fruit," he's struggling when he hits abstract ideas. He's struggling when he needs to encapsulate something into one sentence rather than one paragraph. He cannot group ideas with a label and refer to them to make a topic sentence in a paragraph or to write a concluding sentence. Another example, his theory of mind can pass for pretty typical, until you ask him questions. Then you find out that he had a third way of looking at something that caused him to respond correctly, but he was not responding correctly for any socially typical reason. This shows up in his sense of humor too.

 

So, don't panic, but do keep an open mind. And as frustrating as my son's issues can be, there are things that I love about my son that are what they are because he has autism. I love that he can be a little boy and a big kid at the same time. He has the maturity to put on the big boy pants and find age-appropriate activities when it's appropriate to that setting or group of kids, or else I would not find that charming. But I love that he doesn't stop enjoying the more childish things as well. There are other areas where this is a problem, but it's very sweet on a mom to son wavelength. It's also kind of fun for neurotypical peers that know him well--he has one good friend 9 months older who will play big kid stuff with him and add in the fun, younger kid stuff at the same time, and neither of them are embarrassed or think anything of it. I suspect the other boy likes the chance to trot out his stuffed animals and things like that without having to be a big kid to impress anyone. 

 

Whatever way the diagnosis goes, ADHD, SPD, and ASD all involve self-regulation issues. Starting some OT, learning the Zones of Regulation program, and working on behavioral stuff will be helpful for all of those issues. It won't be wasted time.

[PeterPan]

SPD is an OT diagnosis and is not in the DSM. If you see the form the OTs use to diagnose it, you'd think you got handed another ASD survey. 

 

I agree with the others that it takes a long time to sink in.  I don't think any teacher would use the A word if they had not been seeing a fair number of things that, in their mind, indicated that.  I think the best way to sort it out is to take him to the best autism clinic you can find.  Get three opinions if you want, mercy.  But I'm just saying you might as well hit it head-on and let an autism expert tell you it's NOT.  That way you don't have the unhappy situation of realizing the non-ASD expert missed it.  

 

Fwiw, a teacher was the first person outside the disability community to use the A word with me about ds.  If it's a teacher with a lot of experience (like this one was in our case, 35 years!), they've worked with SO many kids, they see subtle differences.  I wouldn't ignore that, even if it's not the answer you wanted.

 

If it's *not* ASD, you need a good explanation.  I would take him to an audiologist to get him screened for basics and APD.  That would be another way to get the symptoms you're describing.  You still need the psych eval, but I'm just saying that would be another way to get there.  But hiding under the table?  He needs some support and he needs the label that's going to get him that support.  Don't be afraid of the label.  You want the label that gets him access to the services he needs.  My ds has been this skittering under the table thing.  It takes a LOT of support, using a whole bunch of things, to get him to a better place where that's not happening.  If he's in school, he needs ALL the evals (OT, SLP, psych, audiology, etc.) so they can work through it and make a complete package, an IEP that will give him a variety of supports to put him in a better place.  That's our whole thing this year, what we're really working on.  Sensory breaks, better communication, visual schedules, things to get his body more stable (LOTS of OT stuff), etc.  But it's not all OT.  They'll stuff some of it under there, but people who get more aggressive interventions early have better outcomes.  If he needs things, you want to find out NOW and intervene now, not later.  

 

Keep going.  Sounds like you're doing the right things!

[Lecka]

I think it could be one of two things.

 

One, the teacher said "autism" to be factual (she has seen it in that population) and to express "this is not some little thing."  She could be meaning "don't let this go, and think it is just normal kid stuff, please bring in an expert to help me meet his needs."

 

I think that is very possible.

 

B/c from what you have written -- I don't see autism there.  I think that could be ADHD and SPD.  Locally I would say -- he needs to be observed by an OT and see if he can get some accommodations or sensory breaks or whatever the OT recommends.  Maybe a safe space in the classroom for him to take breaks.  Like -- what if they had a desk in the back of the room, and said he could go there if he wanted, and he did that instead of hiding under a table.  That is a strategy that an OT might recommend.  Stuff that is not a big deal, but can go a long way for kids and teachers.    

 

Two, it is possible the teacher does see more, but this is the "obvious" thing for her to bring up.  Maybe she is feeling you out, to see if you are open to hearing things.  Maybe she is giving a hint now, so it is not a huge shock if it comes up later.  Teachers do things like that.  If you had said to her, "we see this too" then that would lead to a different conversation.  For all the teacher knows -- you are seeing more, or you have seen more, and you just haven't mentioned it.  Teachers are not mind-readers, they have no way of knowing.    

 

But I think at face value -- the teacher is letting you know, this is not behavior where they say "oh, we see this at a lot at this age, there are a couple of kids every year, it is not a big deal."  I don't think it is saying "this is a big deal," either.  It is just a signal "this is not something where you would be over-reacting if you investigated."  

 

I think teachers say more/different things to parents who seem like "I don't want to over-react" or "I don't want to make a big deal" than they do to parents who might seem like "I want to start at once at the smallest sign of a problem."  

 

B/c of this -- I don't think you can take their words at face value sometimes!  I think they can be saying something to hint at one thing to one person, and will say a totally different thing, to hint at the same thing, because they are talking to a different person.

 

But I am horrible at figuring out what teachers mean.  I do think, though, you can't just go by exactly what they are saying, you have to try to figure out the context and the intent they are trying to communicate.

 

I think, though, if the teacher said "here is a problem" and you said "blah blah" and the teacher thinks "oh, the parent thinks it is not a big deal," then the autism comment could have only been meant to convey "yeah, you are seeming to blow it off, and I don't think you should blow it off."  She could *easily* have that intent if that is the context, and it could mean nothing as far as thinking your child has autism.  

 

But if she was trying to get your attention a bit, it worked, so it seems like it was successful communication in that case?  

 

I don't even know.  

 

[kbutton]

Lecka makes some very good points about teachers and communication. Teachers did not know how to talk to me when my kid was in school. I didn't know how to talk to them. It was a mess. My son had behaviors at school he didn't have at home and vice versa, which didn't help--we had to get the school counselor involved one year so that we could find out what was up. She observed class and helped bridge that gap when the communication wasn't working.

 

I had better communication with the first teacher we had--she let me know at the end of the first quarter that she was pulling out her hair (nicely, tactfully, and in a way that she was soliciting my help). She described things that I could see behaviorally without a lot of judgment, which helped a lot. She just wanted to know what to do when he did those things, not blame him or me. We hail from similar parts of the country, so I think we could communicate more easily. I found out a year or two later (literally, when it occurred to my son that he could talk about it), that he thought his first teacher was always upset with him, and he had a harder time complying. She a very nice lady, but she does have a no-nonsense face, and it became apparent over time that my son could only put emotions into two buckets: positive and negative. If we had known that, I think the experience would have been extremely positive instead of good with some misunderstandings. Once i explained to my son that she wasn't mad at him, she just needed him to know she was serious, his perception of her went from mostly positive but confused and wary to pretty much all happy memories of her class, lol! 

 

But we had no diagnosis at that point. The other two years in school were just odd.

[SarahW]

Thanks for all the replies. I am carefully reading them. I have a lot of balls in the air (getting on an airplane in just a few weeks!), so sorry if I'm a bit brief in my posts.

 

I've also been poking around the internet and ordering more books through the library. Bright Not Broken is one, and some others. Hmm..I didn't think that 2e might mask the "classic" signs of ASD.

 

I figured that my kid was quirky. But when he was in K we had numerous meeting with his teacher. And our church nursery was run by a lady who was a teacher at a local special needs school (Down's, blindness, and other kids who couldn't be mainstreamed, which I'm supposing included some kids who had extreme autism) and my kid joined in the summer day-camp she ran for some of the students. ASD was never mentioned (neither was ADHD or SPD for that matter), instead I got the feeling from them that they thought I was overly indulgent with his avoidance and "spaced out" behavior. The most direct question I got asked was "Is everything okay at home?" Uh, yes, yes everything is fine. Huh?

 

I can understand missing ADHD-Inattentive in a 5yo, but ASD? So I feel like this is coming from left field. I don't think I'm in denial, just confused.

 

Dh was supposed to call this week to get the eval appointment process started, but forgot. He outsourced that task to someone with a working memory (MIL) and she'll call Monday. Hopefully we can get an initial eval in NL, and then probably do it all over again in the UK. So those will be two entirely independent evals. I guess that it will take a while before there is any clarity.

 

In the meantime...wondering if there is anything else in particular I should do at home with him, other than let him run around and bounce and have a chew toy, of course. I know reading comp curriculum and things like Wordly Wise get a bad rap around here, but I wonder if they might be good for a student who needs to be explicitly taught how to make inferences or pick out the main idea or learn what words really mean. And I wonder if my kid is that sort of student.

 

"Crazypants" comes from Spongebob Squarepants. DH and I would sing the theme song really loud, putting kiddo's name in there and swapping out the words for even crazier words, lol. "Crazypants" stuck. We're a family who takes "embrace the weirdness" very seriously. :D

 

Gotta run.

[nature girl]

Could it be that the reading comp issues are just from the ADD? At my DD's neuropsych eval, they read her short stories, and within a few minutes she wasn't able to answer related questions. The neuropsych guessed that the reading comp issues were more focus-related, rather than comprehension (and I have to agree because when we read stories she's interested in, she'll describe them well to my husband and can talk about them for days, even write her own short summaries of them.)

 

It sounds like he understood the graphic novels (and encyclopedias.) Would he have been able to make inferences from them if quizzed? Do you think the issue might carry through to all reading, or maybe just reading he's not as interested in? Since he's not drawn to reading in general, that might be true of the vast majority of books. The idea of a regular reading comp. program makes my eyes roll back in my head, but if you could find that next genre that he's interested in (fantasy? Maybe hit him up with Narnia/The Hobbit/Harry Potter/Nesbit or The Water Horse or something similar, and then just discuss the books together?) I'd only assume an actual issue with reading comp. or processing if you could rule out lack of focus as the reason.

[Lecka]

I think you might point-blank ask the teacher what she meant by her use of the word autism.  Say "I feel concerned that you said he is exhibiting some behavior you have only seen before when a child had autism, what did you mean by that?" or something like that.  

 

Or maybe that is too blunt, maybe you could ask "when you said that, did you mean you think our son could have autism?"  

 

I think it might have been an off-hand comment on the teacher's part.  Or -- it is a true statement, but is not meant not to imply anything about why your son might avoid music time.  

 

I think it is worth asking.  

 

I think it is too bad to worry or go off-track if the teacher did not mean anything by it.  And if she meant something by it -- find out what she meant!  If she is seeing more, or if that is all she is seeing ----- either of these are great information to have.  

 

 

 

[kbutton]

Inference Jones by Critical Thinking Company is good, but it's for older kids. If he's reading third grade material, you might start. Or you might inference more informally. On the very beginning end (to keep this brief), books like Clifford the Big Red Dog offer inferencing--the descriptions of the pictures are often understatements of what is actually happening in the picture, or require the child to read behind the lines. They are probably not appropriate for your son, but it can give you an idea of how to make some informal inferences.

 

Main idea and inferencing are skills that all kids struggle with to some extent, so don't sweat them too much unless you see a real problem brewing. It's also not a problem to teach them explicitly as long as you're not asking for something that he isn't developmentally ready for.

 

It's never bad to teach vocabulary explicitly if you think it would help. You might check into programs that use word roots. My son picks up new vocabulary easily in context, but he's kind of stressed out by vocabulary in isolation. My other child needs explicit instruction. 

 

I have no interest in convincing you that your child has ASD when I haven't heard enough to know that is the case. But, I honestly see you saying all the same things I did, right down to people thinking I was indulgent, etc. But that's just offering an opinion on your situation and what you should consider, not discussing your son explicitly, so things could be more straightforward and only be ADHD. My son didn't seem all that spectrum-like until he was about 9. Prior to that, he had toddler behavior that could have tipped someone off, but he mostly came across as strong-willed. There is a reason that 2e kids get diagnosed later or are missed entirely for years. His gifts really do camouflage a lot. Our tutors found this to be the case as well, but they see commonalities between him and the other kids they work with--it's just showing up in less obvious places much of the time.

 

I do think you should take Lecka's suggestion.

[Lecka]

I have to admit, part of me hopes that if the teacher does think "autism," she would bring it up in a more thoughtful way.

 

It could have been a lot more thoughtful than from my impression. I am just having an impression where the teacher said it on the casual side.

 

It seems so foreign compared to how carefully I have heard it used... When it is still the big A word!

 

It would make more sense to me if the teacher was just saying it randomly instead of more thoughtfully.

 

But I really cannot figure out teachers. I am at the point where I routinely try to assume they have meant the opposite of what I thought, and see if that makes more sense, then assuming I am understanding what they mean.

 

Ime they say serious things in a very friendly, "don't worry" way. When they say things that seem short and serious, well, that is no big deal, it just means they didn't pre-think the conversation to make sure they seemed nice.

 

But as a parent I am supposed to know this?

 

Sorry.... One of my pet peeves, and I have some school meetings coming up.

 

And, I have much easier communication apart from classroom teachers. The special Ed teacher is easy to talk to, and the speech teacher, and OT. I think it is just their comfort level, they are straightforward .

[SarahW]

Quickly, I'm not sure what exactly the teacher said. He spoke with DH, and DH translated the gist of it over skype to me. I believe DH told the teacher that we were considering getting evaluations, and the teacher said he thought that was a good idea, and it stopped there. So... In NL there's a "leave it to the professionals attitude" so the teacher probably has no idea that his comment would lead to me getting a stack of books from the library. Dutch parents would be more likely to just make the doctor's appointment and then think their job is done until the doctor gives them further instructions. I can ask DH to go back to the teacher to clarify, but the teacher probably considers more info would be best from a different professional (the neuropsych). But maybe my DH can ask if they can try out some accommodations and see how it goes.

 

"Strong-willed" fits Cp to a T. But it also describes myself, when I was in preschool I was taken to a school therapist for being largely non-verbal and the only diagnosis given to my mother was that I was "strong-willed." (My family thinks this story is funny, I'm coming to think of it as being horrifying). But when Cp withdraws from something, forcing him to participate is not possible. Any reasoning or cajoling just makes him shut down further and get more emotional. And I'm definitely not going to threaten him with a leather belt, like my mother suggests.

 

Re: reading comp - my DH is reading a book of Irish myths with him and having him do a narration. This is going well enough, myths are pretty short and very vivid, lol. But DH also had him look for words he didn't know, and Cp declared that he knew all the words. So DH picked out some harder words and asked Cp to say something about them, and Cp couldn't. I know giving a definition off the cuff is difficult, but for a word like "tyrannical" you can describe what it is like if you know what it means. DH had him look up the words and write down the definition, and Cp eventually decided that DH and I were not "tyrannical" (oh good!).

 

He prefers watching science documentaries over reading (even boring documentaries for adults), and I feel that there is an issue with him getting full comprehension when he reads, so it frustrates him (so he avoids it, so he doesn't build fluency, so he doesn't build comprehension, so he avoids it, ad infinitum). We've done popcorn reading (Charlotte's Web and others), I have him read out loud (Christian Liberty science reader book 1 and other things), and Dh and I read to him (lots of different things). But I still feel his reading ability lags way behind his ability to abstract and conceptualize, and I can't quite put my finger on why, or what I can do about it.

[Lecka]

That withdrawing and shutting down behavior sounds like it could be autism.

 

There are a lot of great strategies for it for autism, that are also used in general. Autism has a way of getting strategies first, that then get used more broadly. It is where a lot of people are working right now.

 

I think you can't go wrong if you look at stuff about Aspergers or HFA for that.

 

If you have an example of a time he has shut down and what the reason seems to me -- there are some reasons that would come across more like autism.

 

For the reading, you might check out Thinking in Pictures by Temple Grandin. She thinks but she is not always thinking in words and with language. I think Dyslexic Advantage has some similar stuff, where people are very smart, but not thinking in a language-y way so much. Something like that could be part of what you are seeing.

[PeterPan]

Don't ask non-experts to diagnose your kid.  The teacher can put her finger on it and say something is not right, but she's NOT a psych, not an autism expert.  Same deal with SLPs, etc. Even if they work with a lot of kids with ASD, they can get confused by the complexity of the less common presentations.  Sometimes they're so close they don't see it as an outsider does or don't see him in other situations.  That happened with us.   Get the evals with an autism expert, get it sorted out.

 

[kbutton]

I think one of the best (but driest) books that gives some perspective on 2e kids who might be sprectrum-y or ADHD is Different Minds by Dierdre Lovecky. It was written when Asperger's was a diagnosis, but it's very good. It differentiates ADHD, Asperger's, and non-verbal learning disorder and also shows the overlap. It has a lot of anecdotal incidents for illustrations, and it's very thorough. It sometimes covers combo presentations--ASD with ADHD, for instance. It's not a diagnostic book. It's a book that is supposed to give you insight into their thinking, their challenges, and how to support them in various settings. It put words to what I was concerned about with my son.

 

This is the website for the organization she directs: http://www.grcne.com/ 

 

I think you need a professional to straighten this all out. Even if you become certain it is autism, the fact that autism is so diverse means that you only have the basics of a way of moving forward. Language testing sounds like it would be something that would help you out even if it's not determined that your son is struggling overall with language--he could have peaks and valleys in his language development, and that could be what you are seeing. 

 

You may also have some mix of external factors that really is just yanking his chain, and it might not be autism--it might be bits and pieces of other stuff. If he's shutting down from those other factors but not in ways that are more typically autistic, the diagnosis could be surprising. 

[kbutton]

We are all willing to chat out what you are seeing though--it can be incredibly helpful to talk things through so that you are sure you're presenting all the relevant information to a professional.

[PeterPan]

That's great that you're pursuing evals and that your dh is on board with it.  They can run detailed language and pragmatics testing and sort out what he's understanding and where the holes are.  With my ds there was a HUGE discrepancy between his vocabulary and what he actually understood when given a single sentence.  Usually in pragmatics testing they'll look at inferences, etc.  You're probably not looking at just *one* explanation.  It can be the executive function and pragmatics, all because of the larger issue of the ASD/ADHD.  The testing helps you go in with targeted therapy to work on it.