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The first time someone told me they wondered if my daughter has ADHD, she was four years old. Her preschool teachers said that, although she was grouped with students who needed less guidance academically, she often would get distracted while walking from one end of the classroom to the other. She also had to sit in the back during Rug Time because her constant movement and downward dog-type poses distracted her classmates.
She’s now in third grade and a conversation, a few days ago, with her current teacher was similar.
She still forgets where she’s going midway across the classroom. And when the teacher played classical music recently, during independent work time, my daughter stood up and seemed to be in a totally different world. When another student asked her to sit down so he/she could see the board, my daughter “came to” and looked embarrassed. The teacher approached her and asked her quietly why she was standing. She said she didn’t know.
As a mom, it’s tough to hear her daydreaming and forgetfulness are impacting her that much at school. It concerns her teacher, too. Mrs. G said she can tell how frustrated my daughter gets with herself and the anxiety that it creates.
Careful diagnosis
Based on what I’ve described above, you’d think ADD/ADHD for sure, right? Three years ago, I would have agreed.
Here’s the thing, though. Because of my oldest child’s social struggles, I’ve learned that misdiagnosis is surprisingly common in “gifted” children.
It’s the danger of not understanding overexcitabilities (a.k.a. intensities) and asynchronous development.
Here are a few statistics from a 2011 study:
- “Gifted” children are more than eight times as likely to be considered or treated for Asperger’s or autism spectrum disorder than the pediatric population in general.
- Almost four times as many are considered or treated for OCD.
- More than three times as likely to be diagnosed with sensory processing disorder.
- Nearly three times as many are considered or treated for ADHD.
For more on this topic, read my misdiagnosis article.
Getting an accurate assessment
The first time I heard “maybe he has autism” was the day after Thanksgiving. My son was only 4 months old, at the time, and my brother-in-law’s new girlfriend (a nurse) was trying to figure out why my little guy freaked out so bad – and for so long – when people approached him.
I heard the same suspicion two months later at a friend’s birthday party. And again, at 7 years old, when I took him to a play therapist. Thank goodness he craves social interaction so much; it seemed to silence that suspicion fairly quickly.
With ADHD, it seems even more important to get the diagnosis right because the topic of medication comes up so quickly.
My daughter is very creative (possibly to the point of having the imaginational overexcitability). In fact, a friend said yesterday, after watching her “perform” drinking hot chocolate, that she’s so extra. That is true. It’s a great way to describe her!
She also appears to have heightened sensory experiences when it comes to smells, textures and visual input such as art.
And remember that instance in which she seemed to “be in another world” when the teacher played music? My daughter makes up song lyrics all day, every day. She’s like a walking musical. I’ve heard more than once how much she hums in class and then other kids begin to do it, too. (Bless her teachers!)
Oppressive worrying
There’s definitely some anxiety in the mix, too – which can have a major impact on executive functions. (What prompted the conversation with her teacher last week is my daughter’s increasing math anxiety.)
Her current teacher says she considered Response to Intervention (RTI) for my daughter – an approach to help struggling students catch up before they fall really far behind. “However, I don’t think that will help with what she needs because it’s not academic. She is more than capable and smart.”
The teacher also said, though, that she doesn’t want to send my daughter to fourth grade with these challenges because they will cause even more stress than she’s already experiencing.
The crossroads
So, how do we examine the degree to which anxiety is present – and contributing to all of this? And how do we determine whether she has ADHD, an anxiety disorder, is legitimately “gifted” in some way, or falls into more than one of these camps? When two or more apply, we call these kids twice exceptional (2e) or multi exceptional.
Do I care whether or not my daughter is “gifted”? Not at all. I simply want her to be confident and to have the tools she needs to pursue whatever avenue(s) interest her.
I also want to ensure she isn’t being prescribed ADHD meds unless she truly needs them.
Next steps
It’s delicate work to tease all of this apart and understand what’s really going on. Therefore, I’ve identified a child psychologist who thoroughly understands each of these conditions; the interplay between them when two or more are present; and the ways in which these traits can appear to overlap, but don’t.
This analysis isn’t cheap, but it’s important. The consequences can be disastrous when physicians and mental health professionals don’t get it right.
I’ll provide an update once I know more.
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