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I am greatly concerned about my 14yo dd. She is also having neuropsych. testing done this month, so I'd like to pick your brains and see what you think I should present to the np and what questions I should ask.

 

She was diagnosed at age 10 with an anxiety disorder.

 

She spent 5 days in a psychiatric hospital at age 11 and was diagnosed with bipolar disorder. She is bipolar I and her latest was a mixed episode.

 

She is extremely intelligent, esp. in writing, reading, spelling and creativity. She is always coming up with something interesting for my other children to do or play; writes poetry and songs and stories (has had many compliments from people who know good writing); has a beautiful singing voice; is a 'deep' thinker on world issues and moral issues.

 

OK-- the 'issues':

 

She is terrible at math and has pretty much stood still in math since 3rd grade. She cannot seem to remember her multiplication tables.

 

When she is doing math or other work that requires keeping track on a page of questions and answering on another page, she writes things down incorrectly or doesn't line up problems correctly.

 

She has absolutely no common sense and lacks logic. Recent examples:

-She made a smoothie and I told her to wash the blender. She put the entire blender (base an all) in a sink full of water to soak overnight.

-She thought something smelled funny in the house, so she used furniture polish as air freshener. Unbeknownst to me, until she came into the kitchen and started spraying it literally inches from the flame of our gas stove, where I was cooking.

-I told her to mix up chili and put it in the crockpot. She did a very good job mixing it up, put it in the crockpot. An hour later I went to serve it for lunch and .... she had not plugged in the crockpot. I asked her why. "You didn't tell me plug it in."

-Today I told her to clean the litter box. She did, and then left it completely empty. When I asked her why she didn't fill it up she said, "You just said to CLEAN it out."

She's not being sarcastic when she answers. She really is being truthful.

 

I am concerned that she is almost 15 and is nowhere NEAR ready to live outside our home. She would never change her clothes, she'd probably burn her place down somehow.

 

I have a hard time figuring this out. Is this part of bipolar? Is it something else? Is it ADD?

 

What would you ask the NP and what symptoms would you tell him? I don't really want to go in detail in front of her, because she feels dumb about these things.

 

Any ideas?

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She has absolutely no common sense and lacks logic. Recent examples:

-She made a smoothie and I told her to wash the blender. She put the entire blender (base an all) in a sink full of water to soak overnight.

-She thought something smelled funny in the house, so she used furniture polish as air freshener. Unbeknownst to me, until she came into the kitchen and started spraying it literally inches from the flame of our gas stove, where I was cooking.

-I told her to mix up chili and put it in the crockpot. She did a very good job mixing it up, put it in the crockpot. An hour later I went to serve it for lunch and .... she had not plugged in the crockpot. I asked her why. "You didn't tell me plug it in."

-Today I told her to clean the litter box. She did, and then left it completely empty. When I asked her why she didn't fill it up she said, "You just said to CLEAN it out."

She's not being sarcastic when she answers. She really is being truthful.

 

I am concerned that she is almost 15 and is nowhere NEAR ready to live outside our home. She would never change her clothes, she'd probably burn her place down somehow.

 

I have a hard time figuring this out. Is this part of bipolar? Is it something else? Is it ADD?

 

What would you ask the NP and what symptoms would you tell him? I don't really want to go in detail in front of her, because she feels dumb about these things.

 

Any ideas?

 

The above examples of no common sense and lacking logic sound much like my son. I often get the "but you didn't tell me" when I go to check on something he was supposed to do and I look at and think it's half done. He says I didn't tell him, it's almost like he needs step by step instructions. I do understand she is not being sarcastic only truthful when she answers as does my son.

 

My son has an AS diagnosis. I am no doctor, I am only seeing somethings that ring a bell with us. I would type out a 1 page bullet point paper for the doctor who is doing the evaluation. Include anything you think might be helpful. This way the evaluator can read the paper and you will not have to speak in great detail in front of your daughter.

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I'd write up these symptoms and give it to the np so that you don't have to say all that in front of her. You're describing a pretty significant lack of language pragmatics (she is taking your language very literally) as well as deficits in daily living skills. I'm guessing that this also impacts her social relationships because peers will draw back from the "cluelessness." The WISC-IV should be helpful in sorting this out, if there is a gap between verbal and spatial IQ score, they will probably look at NVLD. The good news is that the language pragmatics can be taught.

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Wow. Thanks to both of you. I would have never gone that 'route' in my thinking. I'll have to do some research on that.

 

It's interesting you mentioned social skills, Laurie. We took dd out of ps when she was in 6th grade, which was also the beginning of middle school for her. In elementary school, she had been popular, out-spoken on what she believed as far as right vs. wrong, well liked by her teachers and had excellent grades (besides math).

 

In middle school, she fell to pieces. She had a wonderful guidance counselor that I communicated with often and at one point she told me that she felt dd could either handle the 'academic' part of school or the 'social' part of school, but not both. Dd had chosen the social. She had a TON of friends. However, she was not faring well with classes, keeping it all together, etc.

 

Hmmmm.... this is very interesting. She doesn't have many friends now, but I attributed that to us moving here 2.5 years ago and it's a hard homeschooling community to break into. Most people have been here for years.

 

Wow again. I never thought about language pragmatics. Very interesting.

 

So, as far as her math goes, would that fit into what you both mentioned or would that be another type of learning disability altogether?

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So I'm guessing that her high intelligence in other areas has kept this from being 'caught'?? I can't imagine how she went through 6 years of ps without someone seeing something. I'm not saying I don't believe you all that it could very well be NVLD. Just that I'm so surprised ps didn't catch anything.

 

All she got in 6th grade was "feedback" that she wasn't organized, wasn't responsible.

 

This is totally different from what I was thinking... I was thinking ADD. So now I'm shifting gears and it's slow churning. :D

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It sounds a lot like NVLD to me, as my son was just diagnosed and I have been reading everything I can about it. The math difficulty, taking things literally, and other things you mention. I would check out some websites. Often the behavior can look like ADHD and it can be misdiagnosed. As the child approaches middle school age problems with anxiety and depression can set in. This site lists links to several others. Hope it helps! Good luck!

 

http://www.uniquelygifted.org/nld.htm

 

Thank you! I will check out that link.

 

I'm really glad I posted because I think my mind was going in such a different direction that I hadn't considered anything else.

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This could be part bipolar as well as NVLD and/or ADD. ADD and NVLD can go together as well.

 

As others suggested, I would write down all of your concerns--just like you did here with examples--and then either hand it to the NP or ask to speak to them alone. I do that, my girls wait in the waiting room while I talk first for a few minutes. I do think it is wise to not talk about this in front of her but the doctor does need to know.

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My first thought was NVLD, too. It often is undiagnosed until middle school when the demands of academics get more complex. Children with this are often extremely literal and have trouble drawing inferences. Having a high IQ sometimes allows the child to go by unnoticed also. It sounds like your daughter has many strengths. The neuropsych should be very helpful. Good luck.

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The math difficulties are part of what jogged that particular thought.

 

Keep in mind, though, that NVLD is a syndrome still being researched. It is not yet in the Diagnostic and Statistical manual. People disagree on the criteria and it will take a while to shake out.

 

If she did have a lot of friends in middle school, that dx may not fit. Don't do too much research until you've got the eval. results.

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I have not read the other responses, but this sounds like Asperger's or Nonverbal Learning Disorder to me!!! She sounds exactly like my daughter. The way she is so literal and so smart, but struggles with math, etc. Definitely have the psych test for Asperger's and NVLD. My 5yo daughter has both and my 11yo daughter is somewhere in the middle, has symtoms of both, but can't be diagnosed so far.

 

Oh, and many girls with AS also have bi-polar and anxiety.

 

Good luck!!!

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