Interesting feedback on DS evaluations and some questions

[SamanthaCarter]

Ds was diagnosed ADHD combined type over a year ago, but I was unwilling at the time to put him on meds without more feedback, support. So we had him evaluated by a guy who came highly recommended by several people. We heard the results today. The psych agrees with the diagnosis. He also found a huge gulf between ds's very high verbal and visual-spatial scores and his working memory, executive function, and some other processing stuff. (Sorry, I know nothing about this language and I don't have the written report yet). It confirms parental hunch, which is sort of a relief.

 

The doctor says one of the best thing we can do for him along with meds is to provide a very structured educational and home environment for him, so that he knows what's coming and how to plan for it. This scares me a bit. Neither my dh nor I came from highly structured households, nor have I ever tried to run one. I feel out of my ability. We've always just kind of gone with the kinder-flow around here, for good or ill. Please help me.

 

Also the doc seemed reluctant to say that you can improve working memory, rather than just scaffold it indefinitely. I'm getting mixed messages from Dr. Google. Can you or can you not improve working memory?

 

 

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[Hilltopmom]

Come on over to the Learning challenges board :)

 

youll find past posts about WMthere too

[73349]

The doctor says one of the best thing we can do for him along with meds is to provide a very structured educational and home environment for him, so that he knows what's coming and how to plan for it. This scares me a bit. Neither my dh nor I came from highly structured households, nor have I ever tried to run one. I feel out of my ability. We've always just kind of gone with the kinder-flow around here, for good or ill. Please help me.

 

 

Here are some ideas for structure. You may already be doing some of them without thinking about it as structure.

- Have a large wall calendar in the kitchen and write holidays, birthdays, and everybody's events on there. The FlyLady sells a nice large one. You might want to get some stickers or small stamps for recurring events (e.g., scout meetings every second and fourth Tuesday night).

- Try to keep the day's main events, like meal times and bedtime, at about the same time each day.

- Each morning, make sure your kids know what you plan to do that day. A pocket chart is good for things you want everyone to see, or you can use a list for each person.

- Try to do things in the same order. That helps kids internalize the steps. For example, in the mornings, we have breakfast, brush teeth and get dressed, do a morning chore, then have piano practice and meet at the school table.

- Have your DS's room uncluttered, and make it easy to put things away and to find them again. For example, use a divider to separate hanging short-sleeved shirts from long-sleeved shirts; label dresser drawers.

- Use checklists for things to remember.  (When we're going swimming, you need your swimsuit, sandals, towel, sunscreen, etc.) You might want to make several for different purposes and put them on the fridge or a bulletin board near your usual door. It can take a long time to build the habit of looking at the list, but it's worth doing!

- Color-code anything that makes sense. All orange things for the oldest means you don't need to ask who left this orange towel on the floor or that orange pencil on the couch. (I only have one kid, so I color-code the days of the week instead. Monday = red, Tuesday = orange, etc.)

- Have house rules in place rather than having to make a decision every time. Can we watch TV before school? Who clears the dishes? Who is responsible for getting library books returned on time? What happens if my sister breaks my toy? I hear the ice cream truck--may I have $5? If there's a long-standing policy, kids are unlikely to forget, nag, fail to hear you, or otherwise seem irresponsible.

Edited June 20, 2017 by whitehawk

[Arcadia]

Also the doc seemed reluctant to say that you can improve working memory, rather than just scaffold it indefinitely. I'm getting mixed messages from Dr. Google. Can you or can you not improve working memory?

Whether working memory and/or processing speed can be improved is so YMMV.

 

How old is your son as I can't read signatures on my phone? My DS11 needs structure and help with executive functions skills. My DS12 demands structure from when he was a newborn. Need to know what to expect and likes things to be running like clockwork. That is why he homeschool like a public school kid.

[Arcadia]

Your son is around my younger boy's age.

 

One page poster on working memory and brain plasticity by UC Irvine

http://wmp.education.uci.edu/files/2011/03/Lab-Poster-2015-UCI.pdf

 

8 page PDF

Training and plasticity of working memory

Torkel Klingberg

Department of Neuroscience, Karolinska Institute, Retzius va ̈g 8, 171 77 Stockholm, Sweden

http://www.klingberglab.se/pub/Klingberg2010_TICS.pdf

[MerryAtHope]

Workboxes were so helpful here--they know what subject comes next and exactly what's expected from their school subjects each day, and that's a big chunk of the day. Not everything in life can be planned, and I continued to let my one who struggles with that especially know that--I think part of preparing for life IS learning how to deal with the unexpected. But having some things planned and predictable, and doing that as much as possible, helps them have the resources to try to deal with things that are not that way.

[Jackie]

I'm in this very confused boat with you. My daughter was just diagnosed ADHD. I already knew it was a correct diagnosis, and the official psych workup was simply confirmation. Honestly, I'm just waiting for us to move and find a doctor in our new location, and then I'm happy to look at meds. I've been beating my head against hard things, and meds would be a relatively easy answer to a very complicated question.

 

I've looked into a lot of the brain training/working memory options and been disappointed. Most of the research seems to show gains while actively engaged in a program, and those gains are immediately lost when leaving the program. There do seem to be a minority of people with big gains, though, so the question is more layered than the current research, I think.

[Syllieann]

I believe my dd has the same strengths and weaknesses, but we haven't been to a doctor. I started doing checklists for daily tasks. She can read, but picture icons seem to work better than written phrases. Maybe that is the visual/spatial strength. Anyway, the checklists help a lot. For things where she feels they will take too long, I set a timer. So she might be required to spend 5'minutes picking up toys, then get 5 minutes to play. I am about halfway through smart but scattered so I am implementing ideas as they come up. I'm also thinking of using cle for math because of the highly structured format and visual cleanliness of the pages. Using some of their stuff with a daily time it is to be done could get you jump started on organizing a highly structured curriculum. Sorry I can't offer more. Hugs. Anxious to hear more ideas from others.

[BlsdMama]

Ds was diagnosed ADHD combined type over a year ago, but I was unwilling at the time to put him on meds without more feedback, support. So we had him evaluated by a guy who came highly recommended by several people. We heard the results today. The psych agrees with the diagnosis. He also found a huge gulf between ds's very high verbal and visual-spatial scores and his working memory, executive function, and some other processing stuff. (Sorry, I know nothing about this language and I don't have the written report yet). It confirms parental hunch, which is sort of a relief.

 

The doctor says one of the best thing we can do for him along with meds is to provide a very structured educational and home environment for him, so that he knows what's coming and how to plan for it. This scares me a bit. Neither my dh nor I came from highly structured households, nor have I ever tried to run one. I feel out of my ability. We've always just kind of gone with the kinder-flow around here, for good or ill. Please help me.

 

Also the doc seemed reluctant to say that you can improve working memory, rather than just scaffold it indefinitely. I'm getting mixed messages from Dr. Google. Can you or can you not improve working memory?

 

 

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People argue this 'til the cows come home.

 

My ds has working memory that operates in the single digit percentile.  It is the biggest educational challenge he faces.  (Impulsiveness and poor choice making is the biggest life challenge.)

A respected neuropsych told me that, for him specifically, because his WM was so low, that stimulants seem to give you a bit more.  My personal feelings on this is that we should have tried the meds years before we did. (Huge regret there.)

 

I would say this - I wonder if it matters if scaffolding just works or if techniques "improve" it.  At the end of the day, he has to learn methods that work for his learning and lower frustration.  I took a job at a brain training facility to learn what they do.  It was out of our budget to use for Tim and I thought if we learned the techniques they would be great for us.  My feelings are very mixed about the experience.  I think it left people feeling as though they had a deficiency to overcome without explaining to them what they were dealing with.  I think some of the techniques (like utilizing a metronome) were actually worthwhile and trained a quicker response/processing speed.  I think we are at the edge of understanding this more thoroughly and while we can all offer opinions, a lot of it is more opinion than fact currently.  Just my .02.

[PeterPan]

The psych is telling you to increase structure, because meds alone are not a miracle cure. You have to COMBINE the meds with behavior/environment/skill changes. There are plenty of books on how to do better with ADHD. I say that very coyly, in the sense of living with a dc with ADHD and maybe addressing ADHD tendencies in the parents. I get what you're saying about how it's not your natural proclivity and that maybe you got by without those changes, but obviously you're going to step up to the plate and give your dc what he needs. Even if a parent got by without those strategies and supports, reality is kids are themselves, their own persons, with their own mix, and their going to need their own, specialized approach.

 

Your psych is correct that structure (predictability, clear expectations, etc.) are going to help IMMENSELY. We've had book lists, but anything by Hollaway is good. There are some books like Smart But Scatttered, and also there was a book on organizing the home for ADHD. That latter book was really excellent btw. It's really something you're going to have to just study, take your time with, and problem solve, bit by bit. If it befuddles you, you can hire a certified educational therapist to help you. They create sort of this intersection point for you, the ped, etc., so you can pull all the strategies and options into a game plan and get things working better. Certified educational therapist. If they're good, they can be AMAZING. There's someone on LC who is studying to become one. It is a really stellar field.

 

I note how bright your sig says your ds is. He's at an age where you're about to see how much his ADHD is holding him back. You're about to leave the randomness (which was totally adequate!) of elementary and go into the increasing expectations of junior high and high school. You're going to have more at stakes, with college testing, etc. This is where it can get ugly. NOW is the time to get things working better and really get in sync in a positive way where you work together and problem solve together. It's less important how hard or "rigorous" or other baloney his work is, and it's more important that he's learning to monitor himself, work a plan, be diligent, meet goals, etc. He's going to need time to follow some personal interests too, some passions. That idea of following a passion, having a mentor, can really work together with increasing structure. It gives you a way to define his day, like ok we're going to work from 9-12 on our list and then work with the mentor from 1-4 on certain days, kwim? That's structure. I'd be stepping it up like that, giving him experiences, definition, a REASON to have a plan and get things done and be on task.

 

I really like the 360Thinking stuff.

[PeterPan]

Yes, working memory can improve, but it's fleeting. I do like metronome work, reflex work, etc., yes. 

 

It sounds like your psych is quietly referring to Cogmed. Cogmed is wicked expensive and does have data behind it, sure. But you look at the data and go ok, how much bump, how permanent were the results, etc. ANYTHING you do that targets the EF portion of the brain will give you a bump. So you can get EF workbooks, do VT, do metronome, etc., there are lots of ways to target that part of the brain! And you'll get bumps, yes. 

 

I personally think it's reasonable to do *something*. Whether it's reasonable to spend $1k+ is really more about your budget.

[SamanthaCarter]

Thank you all for this feedback. I struggle a bit with offering many experiences for DS as we live paycheck to paycheck and that is without extracurriculars, classes, or vacations. I'm kind of on my own. I wis I could hire out some stuff.

 

So far, books make me anxious, because I have trouble figuring out how they apply to us. Smart but Scattered felt like a waste of time. Mindset was super helpful even though it wasn't written toward parenting.

 

 

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[SamanthaCarter]

I need to learn about this metronome.

Edited June 23, 2017 by SamanthaCarter

[Arcadia]

So far, books make me anxious, because I have trouble figuring out how they apply to us. Smart but Scattered felt like a waste of time. Mindset was super helpful even though it wasn't written toward parenting.

 

This book was more useful to me for my DS11 who has lower processing speed but high working memory. I just take whatever tips I could use and my library has the book.

Bright Kids Who Can't Keep Up: Help Your Child Overcome Slow Processing Speed and Succeed in a Fast-Paced World https://www.amazon.com/Bright-Kids-Who-Cant-Keep/dp/1609184726

 

I need to learn about this metronome.

Read this thread and see if it makes things clearer about Interactive Metronome http://forums.welltrainedmind.com/topic/615626-interactive-metronome/

[Reader411]

We are in the same boat.  And yes, it just has gotten harder once DC turned 12.  The brain is changing and maturing but the impulsivity is getting worse. 

 

We keep our house hold run pretty tightly with very clear expectations, rules, routines.  While that is all very important, we are in need of something else to help DC.  It has been a very rough 6 months. 

 

Sending hugs.  (((Hugs)))

[Heathermomster]

Ds was diagnosed ADHD combined type over a year ago, but I was unwilling at the time to put him on meds without more feedback, support. So we had him evaluated by a guy who came highly recommended by several people. We heard the results today. The psych agrees with the diagnosis. He also found a huge gulf between ds's very high verbal and visual-spatial scores and his working memory, executive function, and some other processing stuff. (Sorry, I know nothing about this language and I don't have the written report yet). It confirms parental hunch, which is sort of a relief.

 

The doctor says one of the best thing we can do for him along with meds is to provide a very structured educational and home environment for him, so that he knows what's coming and how to plan for it. This scares me a bit. Neither my dh nor I came from highly structured households, nor have I ever tried to run one. I feel out of my ability. We've always just kind of gone with the kinder-flow around here, for good or ill. Please help me.

K

Also the doc seemed reluctant to say that you can improve working memory, rather than just scaffold it indefinitely. I'm getting mixed messages from Dr. Google. Can you or can you not improve working memory?

 

 

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My 17yo DS has the high verb comp and perceptual reasoning numbers with the low processing and wm numbers. He works with a CBT for EF issues. Our CBT claims that wm can improve, just not by much. I don't buy into the notion myself.

 

Does your son have diagnosed SLDs?

 

50% of children with ADHD will have some sort of motor issue. My DS worked with an OT when he was in 7th grade and developmental motor issues were addressed. He also performed Interactive Metronome therapy, and we saw some improvement. Greatest gains came when DS worked with a ped PT twice a week for about 6 weeks.

 

My DS cannot take stimulant meds, and our non-stimulant med trial was a total bust. As a result of that, DS started working with a CBT. CBT has worked with DS and me providing psychoeducational work and useful real-time feedback WRT goal setting. We have learned some interesting things over the past 15 months. My son doesn't stick to electronic organizers. He can text himself reminders, but for things to actually get done, his tasks must be written down. He uses a simple coil bound notebook and checks his tasks off as they are completed. It took months for DS to see the wisdom of this method. I bolded the aforementioned words because these kids need to see their need for help or they will never buy into the ways you are trying to help them. The goal is for them to successfully organize themselves and complete their tasks independently.

 

We negotiate, write, and sign contracts. I write down specifically what I want son to do, DS will discuss his willingness, and we discuss options if something unexpected comes up. The biggest challenge we face is getting back on a system when life falls apart. You have to plan for when sickness or some other life dilemma arises. Recognizing that the tasks are not being completed is very important too. CBT addresses all that. Anyways, I spot check to ensure DS is getting his tasks completed. I used to offer steady reminders but don't really need to do that anymore.

 

When DS was 11yo, I read the book ADD-Friendly Ways to Organize Your Life and followed several of the authors' recommendations. BTW, DS at aged 17 yo is an entirely different animal than at 11 yo. For them to learn to organize themselves, you have to exercise tons of grace and patience. Developing EF skills takes time and support. Low wm and processing speeds are organic issues. These kids take in information differently than we do, and it helps to remember that fact. It is hard for gifted children to struggle with EF issues because so much is expected of them, and their struggles frustrate them.

 

Here are a few recs that the CBT suggested:

1. Daily rigorous exercise for 1-1.5 hours. DS participates in team sports and enjoys hiking with friends.

2. BrainHQ for 30 min daily...BrainHQ is a boring task and enables the user to deliberately practice sustained attention. DS uses BrainHQ at least 20 min at 4 times per week.

3. 5 minutes mindful breathing 4 times per week.

4. Limit gaming and screen time.

5. Turn off phone during school time.

 

I've explored some organization methods, but I needed the handholding that CBT provides. Here's a list of some materials I have looked at..

 

Seeing My Time

Seeing My Time website

Pomodoro Technique

How to be a Super Star Student

I am in mad love with Cal Newport.

 

Take heart because things will improve with love and consistency. Don't expect any "Shazam" moments like with reading. Improvements present themselves slowly and over time.

Edited June 27, 2017 by Heathermomster

[deerforest]

Just didn't want to leave up details .. I broke my own rule of not posting so much about her personally now that she's older.

Edited June 29, 2017 by deerforest