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Cross-post: ADHD and dyslexic and gifted?


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ADHD (inattentive or mixed) and dyslexic and gifted?

 

What would this look like?  Trying to figure DD9 out.  She's not officially diagnosed with any of the above.  She's started seeing a therapist, but so far, she talks so softly, he's having a difficult time figuring out what's going on.  She's smart, but forgetful.  She spends a lot of time in her own inner fantasy world, and has since she was two.  She is quickly and suddenly angry and frustrated.  She fidgets and bounces.  She reverses letters and numbers still.  When she talks, she starts the same sentence over three or four times, and then in frustration, says, "Forget it.  It wasn't important anyway."  She's polite, but resists authority.  (When the therapist asks her to do things, she tells him, "No, thank you.  I don't want to do that.")

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Your ped can do a spectrum screening as well as the EF/adhd screening tool.  You might also need an SLP eval for that expressive language. You're probably going to need a full psych eval.  

 

Are you trying to figure out what kind of psych?  The screening tools will help you with that.  In general, psychologist, neuropsychologist. If you don't want to see a ped, well an SLP can run those same screening tools, as can an OT.  Just depends on what you think is most pressing and what step you want to make first.  

 

Finding a psych I felt confident in was a challenge. Ask around, google a lot, try seeing who is on the boards for your state support orgs, who's speaking at their sessions, etc. to see if a name keeps popping up.

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My ds 10 is dyslexic, dysgraphic, gifted, ADHD, and mildly on these spectrum. How he struggles with these gifts and challenges changes day to day. He struggles immensely with writing, spelling and still a little bit with reading. He talks constantly but struggles with starting his thoughts in a similar way to your dd. He has extreme trouble focusing and bounces around, or wanders around constantly. He is very rigid, adverse to changes, and has some sensory issues. He has an incredible memory and amazes me with his ability to understand very complex situations. He is very impulsive, loud, and can be see an bossy. He is also very sweet and loving.

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Two of my sons have situations where they show escape behaviors or resistance to tasks.  

 

One is diagnosed autism.  One is not and I don't think he is on the spectrum.  He has had a screening through school for ADHD and does not have it (based on the screening).  He is suspected to have slow processing speeds and processing issues. 

 

I think you might need to get a diagnosis to figure out what to look at.  

 

For my older son, when he is resistant, he is really struggling and he is afraid of failure, he also has experienced failure and so he has an instinct of "I associate this with feeling bad."  It is hard to overcome but he needs to.

 

For my younger son, he is more kind-of resistant and showing escape behaviors by his nature.  It is hard for him to try new things, and he needs to be pushed a little.  

 

They do not need the same approaches, really.  My older son needs to feel safe, and he needs to have success, and he does very well with positive reinforcement.

 

My younger son needs those things, but he also needs to be pushed a little so he can realize that he likes things.  

 

They are both a little sensitive to the rapport they have with people.  They need someone who can understand them and work with them.

 

Does the professional you see have a plan for when she says she doesn't want to answer?  Do you know from talking to him/her, does he/she have a way to find out in another way?  Is he/she going to come at it from another angle?  

 

I would not like it if the professional seemed to be helpless in the face of this stonewalling.  

 

Some kids try to stonewall, and from what I have seen, some professionals, with their background, deal with it very well, and some are just used to dealing with more compliant children.  

 

The people who are good with my boys, like the challenge.  They like kids who make them work a little harder.  I think they are smart and would get bored if their job was too easy.  They think my boys are interesting, too.  

 

It those are not vibes you are getting, it might not be the best fit.  

 

I don't think that is bad, even though I hate it.  Some people I think do just work better with some kids, sometimes.  

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Another vote for the full psych eval ASAP.  What sort of therapist is she seeing?  Typically it doesn't make sense to spend money on therapy until you know what you're treating.

 

With reversals, I'd also want to rule out vision issues with a COVD optometrist - sometimes that's the easiest thing to do first, while waiting for the psych appointment.  I'd have the possibility of sensory, spectrum and language issues in mind also.

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Okay, I totally got the dates wrong on one of the kids' activities, and we've been flying around getting everything done.  I haven't been back at my computer for a couple of days.  So, I'm going to try to respond to everything at once!

Another vote for the full psych eval ASAP.  What sort of therapist is she seeing?  Typically it doesn't make sense to spend money on therapy until you know what you're treating.
 
With reversals, I'd also want to rule out vision issues with a COVD optometrist - sometimes that's the easiest thing to do first, while waiting for the psych appointment.  I'd have the possibility of sensory, spectrum and language issues in mind also.

I'd describe him as a "family psychologist," sort of.  He doesn't specialize in children, but deals with them as part of families that he is treating.  My husband started seeing him first, as one of his areas of specialty is depression in chronically ill people.  DH is diabetic and depressed (and dyslexic -- three "d's!), and schizo something (his symptoms spread pretty evenly between several of the sub-categories).  
  
Our son and I have also been seeing him, so when DD started showing signs of withdrawing and not coping with the stress DH's illnesses put on the family, it seemed natural for her to see him, as well.  It's only since she started that it dawned on us she might have dyslexia.  She learned to read fairly easily, so it wasn't our first thought.  We've wondered about ADHD, as it runs in my family, but her cousins are the other type.  We've known she was bright ever since she was four and DS was six, and she'd shout out the answers to his math lessons before he could open his mouth!   :laugh:  
 
The therapist, himself, has suggested she may need to see a child psychiatrist, too.
 

Your ped can do a spectrum screening as well as the EF/adhd screening tool.  You might also need an SLP eval for that expressive language. You're probably going to need a full psych eval.  
 
Are you trying to figure out what kind of psych?  The screening tools will help you with that.  In general, psychologist, neuropsychologist. If you don't want to see a ped, well an SLP can run those same screening tools, as can an OT.  Just depends on what you think is most pressing and what step you want to make first.  
 
Finding a psych I felt confident in was a challenge. Ask around, google a lot, try seeing who is on the boards for your state support orgs, who's speaking at their sessions, etc. to see if a name keeps popping up.

 Okay, I know an OT is an occupational therapist.  I googled SLP and see it's a speech-language pathologist.  Would that be the person working in the school system?  
 

My ds 10 is dyslexic, dysgraphic, gifted, ADHD, and mildly on these spectrum. How he struggles with these gifts and challenges changes day to day. He struggles immensely with writing, spelling and still a little bit with reading. He talks constantly but struggles with starting his thoughts in a similar way to your dd. He has extreme trouble focusing and bounces around, or wanders around constantly. He is very rigid, adverse to changes, and has some sensory issues. He has an incredible memory and amazes me with his ability to understand very complex situations. He is very impulsive, loud, and can be see an bossy. He is also very sweet and loving.

 Okay.  It sounds like that combination could cause her symptoms, then.
 

Two of my sons have situations where they show escape behaviors or resistance to tasks.  
 
One is diagnosed autism.  One is not and I don't think he is on the spectrum.  He has had a screening through school for ADHD and does not have it (based on the screening).  He is suspected to have slow processing speeds and processing issues. 
 
I think you might need to get a diagnosis to figure out what to look at.  
 
For my older son, when he is resistant, he is really struggling and he is afraid of failure, he also has experienced failure and so he has an instinct of "I associate this with feeling bad."  It is hard to overcome but he needs to.
 
For my younger son, he is more kind-of resistant and showing escape behaviors by his nature.  It is hard for him to try new things, and he needs to be pushed a little.  
 
They do not need the same approaches, really.  My older son needs to feel safe, and he needs to have success, and he does very well with positive reinforcement.
 
My younger son needs those things, but he also needs to be pushed a little so he can realize that he likes things.  
 
They are both a little sensitive to the rapport they have with people.  They need someone who can understand them and work with them.
 
Does the professional you see have a plan for when she says she doesn't want to answer?  Do you know from talking to him/her, does he/she have a way to find out in another way?  Is he/she going to come at it from another angle?  
 
I would not like it if the professional seemed to be helpless in the face of this stonewalling.  
 
Some kids try to stonewall, and from what I have seen, some professionals, with their background, deal with it very well, and some are just used to dealing with more compliant children.  
 
The people who are good with my boys, like the challenge.  They like kids who make them work a little harder.  I think they are smart and would get bored if their job was too easy.  They think my boys are interesting, too.  
 
It those are not vibes you are getting, it might not be the best fit.  
 
I don't think that is bad, even though I hate it.  Some people I think do just work better with some kids, sometimes.

She likes the therapist well enough.  Yes, I think he is used to more compliant children, but, yes, he is trying different approaches.  

 

I've talked from time to time with teachers she's had, at church or ballet or co-op or whatever, and she doesn't cause a fuss in class, so they like her.  But she just quietly refuses to do the assignments she doesn't like.  It's occurred to me that some of them may be assignments she knows she won't be able to do as well as the other kids do, so that sounds like your older son.
 

And "quiet" is a key word.  She can be very loud if she's angry, and if she's super-focused and interested in a topic, she speaks normally, but otherwise, she speaks so softly that if you are sitting right next to her, you can only catch every third word or so.  So even the questions she's willing to answer don't help much.

 

I think that's why the therapist is thinking "psychiatrist," so she can be prescribed something to help her focus.

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I think that's why the therapist is thinking "psychiatrist," so she can be prescribed something to help her focus.

 

FWIW, I think it's far too premature to make the leap to a likely prescription when there isn't yet a diagnosis.  Besides needing the diagnostic criteria to be present, other things must be ruled out first.  Both giftedness and vision issues can be misdiagnosed as adhd (though obviously it's also quite possible to have all three).

 

I would choose a neuropsych whose testing includes IQ and achievement testing and either in-house or referral for language testing and who is extensively experienced with adhd and dyslexia, preferrably with twice-exceptional (2e) kids.  This would be someone who does this all. day. long.  While waiting for that appointment (it can take time to get in!), I'd schedule at least a regular eye checkup with a COVD optometrist to talk about potential vision issues (starting with reversals and all other symptoms you're seeing) and whether a full developmental eval to rule out vision issues is warranted.

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I responded on the x-post... But  I would reiterate, I would look at the Eide's "The Mislabeled Child",  http://www.amazon.com/The-Mislabeled-Child-Solutions-Challenges/dp/1401308996/ref=sr_1_1?ie=UTF8&qid=1398391370&sr=8-1&keywords=eide . Hopefully it will give you a better framework to consider symptoms and diagnoses. Too often parents, teachers, and medical practicioners tend to grab onto the simplest answer and ignore contraindicating traits. As a parent, a diagnosis is less interesting to me than a plan to deal with real functional deficits. A medical diagnosis *may* be the best way to access these resources or it may be a pathway to stereotyped treatments that don't address your actual needs. A more sophisticated understanding of the problems you think are present will allow for a better dialogue if you seek a full neuropsych eval or may allow you to work on the issues on your own.

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The Mislabeled Child imo is outdated on autism.  The rest of it I like very much, and I have checked it out several times from the library.  I seem to keep finding something new every time I read it.  

 

I also can say... my husband and I had a difficult time when we were asked to allow a screening for ADHD for our son.  And then it came back they don't think he has it.  So -- what a waste of time for us to wonder if we would have to make decisions about medication.  He came back with scores a little bit higher (but not in a high range) for anxiety.  I had never had that occur to me, in any way.  

 

Just now, it makes me think, there could be a lot of things, just with the cousins having ADHD doesn't mean she will have the same thing.  Maybe or maybe not.  She may not have anything -- maybe the family counselor just thinks this would be a better fit.  She does have some stressors and that is okay, that is just real life (we have real life also, in my family).

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Adding to what is already said here, ADHD can also be primary or secondary.  If a child has an imbalance in brain chemistry, then ADHD measures with medications or non-medication steps should be taken.  However, a child (like my older son) can have SECONDARY ADHD which is caused by underlying cognitive or neurological deficits and learning disabilities.  My older son had dyslexia, executive dysfunction, dysgraphia, speech-language issues, needed vision therapy, AND was diagnosed with "secondary ADHD."  Our neuropsychologist specifically told us that WHEN we addressed DS' memory and processing problems along with his dyslexia, then his ADHD symptoms would disappear and medication was NOT a solution that would have worked for him.  He had no chemical imbalance in his brain, so adding any attempts at medication to him would have thrown his brain OUT of whack!

The key for our DS was the working memory and processing.. A kid can SEEM ADHD if he can't hold things in mind, but it might be a working memory issue and not an attention issue.  Only a highly qualified neuropsychologist can sort out all of the cognitive functions in a child to determine the root causes of the problems.  When you know the root causes, you can address them with appropriate therapies and programs.  Knowing our son's complete neurological profile allowed me to address each and every one of his cognitive functions, and that enabled us to have a  GREAT outcome!

 

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ADHD (inattentive or mixed) and dyslexic and gifted?

 

This is my 12 yr old daughter. Minus the "H", and I don't *actually* think she's ADD, but she demonstrated strong ADD tenancies when she was younger and if she had remained in public the school probably would have pushed for a diagnosis in that arena. Homeschooling was a huge help, because I went ahead and *let* her do her schoolwork standing up with the wiggly feet and singing to herself constantly and the doodles on her paper. (She has since outgrown most of that behavior.) She was in school for Kinder and a few months of 1st before we decided the classroom was taking too big a toll on her progress.

 

I suspect there are a myriad of answers to "what does this look like?"

 

With my daughter it was crippling spelling problems, massive struggles with math facts and (earlier on) numeracy, constantly distracted and "in her own world", speech articulation delays, figetiness - combined with phenomenal listening comprehension (even if it seemed like she wasn't listening at all), wonderful drawings, elaborate creations, incredible storytelling abilities complete with an early understanding of story arcs and characterizations (though early on, she had to dictate), astute interpersonal insights, great observational skills, and voracious reading. The voracious reading came after initial dyslexia-related difficulties were overcome - but the giftedness masks some of the dyslexia, making it really hard to understand the dyslexia.

 

In these students you may see a phenomenal amount of context reading. One clue for us was - she couldn't spell a thing, and if you asked her to read orally it was a complete mess, but if you gave her a book and then asked comprehension questions, she understood everything she read. The fact that a gifted dyslexic is context reading becomes fascinatingly apparent when you hear these kids talk about what they read and they get to mentioning proper nouns or new words they had no verbal reference for. When they try to talk about the book using these names or words - what comes out of their mouth doesn't remotely resemble the *actual* names or words, save for maybe a key letter or two they latched onto for whatever reason (which may or may not be at the beginning of the name/word). Their brains invent "filler" if they can't draw on their verbal lexicon of known names and words. It's really bizarre, and the opposite of a NON dyslexic gifted reader, who will pronounce unfamiliar names and words with phonetic accuracy to a fault.

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