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Thoughts please-long sorry

Submitted by an LD OnLine user on

ADHD diagnosis. A child presents at age 4 with some difficulties in language and concepts; gets evaluated; providers finding, bright child who is bored with some language concerns. In 1st grade student presents with continued language difficulties and difficulty reading. Child gets evaluated ADHD is ruled out but a language concern is noted. Child moves mid 1st grade prior to school initiating IEP. New school notes no difficulty until 3rd grade. Child again is evaluated and ADHD is ruled out again. 4th grade brings continued problems so child referred again. This time the child is dx’d with ADHD inattentive type. Child given a 504 plan and tried on stimulant. Medications uneffective, continuing difficulty. Finally in 6th grade student is given an official language eval test given HELP—scores 1st percentile to 36th percentile. Full scale IQ is 95. Student receives 1st lanuage therapy at this point. Student moves and starts 7th grade in new district. District reviews past evaluations and changes childs category to Other health impaired from the speech/language category. Child now offered LD classes in math, reading and writing. After 1 year in these classes the students skills improve and teachers comment on what a consciensoius worker he is. Some other interesting scores on childs past testing. Tests of Memory—visual SS 77, auditory 72 learning index 106. On the Tova his scores were normal for errors of ommission and commission for both auditory and visual stimuli except for 1st quartile for visual and last quartile for auditory. But his scores on the rate of response was very low SS 49. Last language scores PPVT III 99, expressive language test 89, WORD test 75 and TOPS 74. My question is do you think his language disability could of been misdiagnosed as ADHD?

Submitted by Anonymous on Thu, 01/10/2002 - 4:50 PM

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Maybe but… I wouldn’t think so. ADD/ADHD can exacerbate other problems present but you’re saying this child had language difficulties. What caused them? ADHD or ADD alone shouldn’t cause language difficulties into the 1st grade. My best guess would be there is an underlying language based learning difference.

Submitted by Anonymous on Thu, 01/10/2002 - 11:51 PM

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Kids with language problems quite often look exactly like ADHD kids; kids with auditory processing problems even more so. If the kiddo is only “ADHD” when langauge skills are involved, that’s a real clue. Bright kiddos who are compensating are *especially* likely to seem ADHD because the LDs aren’t suspected because, hey, the kid is smart, it must be something else.

Submitted by Anonymous on Fri, 01/11/2002 - 5:24 AM

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Many kids that come to me for tutoring who have had a diagnosis of an Auditory or language problem, have actually been ADD. I have seen this more often than not…Part of my own daughter’s issues were impacted not only by her CAPD/ and hearing impairment but ADD. I for one have aced the TOVA and from my understanding the TOVA is not a reliable measure for ADD)according to the TOVA I am not…ADD AM I ADD…? ABSOLUTELY, my behaviors from the time I was 4 years old and even into adulthood can all be tied to ADD. Kids that are ADD-Innattentive have been tuned out of language that surrounds them for years and as a consequence their language skills go down as they get older.

Submitted by Anonymous on Fri, 01/11/2002 - 6:34 PM

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I’ll take a shot at this one. I agree that CAPD and ADD-inattentive can look alike. But one of the things that would sway me toward APD is that they tried medication and it had no real effect. The low language scores and difficulty with reading make me lean more toward APD. I’d be recommending an APD eval by an APD specialist.

All I can think is why the heck wasn’t this kid given speech/language services before 6th grade!!!

Janis

Submitted by Anonymous on Fri, 01/11/2002 - 8:08 PM

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Thanks to all those who responded. I was just curious because as you read about these types of issues they all kind of over lap. Since he was evaluated for a language disability and the issues addressed there has been a signicant decrease in his sx’s of ADHD. He was never considered to be over impulsive or hyperactive just inattentive. He was never a behavior problem either. This year he has 7 teachers 5 of 7 say they don’t see him as having ADHD. They do comment on how quiet he is and how when he is inattentive it is related to a heavy language requirement. They all condsider him to be a hard worker and say he puts forth a lot of effort. 1 of the remaining teachers says the only time she sees the inattention is during the 9 weeks health is taught, for PE he is very attentive and participates well. The last teacher is litature teacher considers him to be very ADD. She lectures as her teaching style and requires a lot of reading. The handout she has are very crowded and also require a lot of reading. I thought since this was his weakest area it would make sense this is where you see the most sxs. He was recently evaluated by his private tutor for reading and writing issues. He scored on SS of 68 for reading and 74 for writing. She has been working with him a few months and says she does not feel he is ADD but is lacking in basic language skills affecting his attention. Like I said it was more a curious thought and wonder if this was seen typically. Thanks again for all the responses.

Submitted by Anonymous on Fri, 01/11/2002 - 8:40 PM

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Janis in his early evaluations a language test was never given. In 1st grade they did just the Slosson, there was no discrepency between verbal/performance so no further testing done. In 4th grade they did the WISC and Woodcock Johnson, there was no discrepency in verbal/performance IQ. There was not enough of a discrepency between IQ and achievement. Full scale IQ was 95, his broad scores on the Woodcock Johnson ranged from 80-90. This is the point where they dx’d ADHD inattentive type due to rating scales. In 6th grade a language eval was requested due to mumbling style of speaking and continued letter reversals. On the HELP test he scored from the 1st-36th or so percentile rank. At this point the speech teacher suggested we get an APD eval. This was accomplished. Findings were moderate APD—but the examiner said it was hard to know wether this was due to ADHD or was a true APD. The speech teacher did a year of EAROBICS with him based on this eval and that is when he started improving. When we transferred to the new district they repeated the language portion of the assessment and still found a moderate language disability. With these results they were able to offer him LD reading, writing and math. This has further improved his skills and performance. We have now hired a private tutor and she feels he does not have ADHD but a moderate language LD. She has been a God send. Thanks for your thoughts and insight. The reason I asked the question is with him going to high school next year I am sure the teachers will ask questions. Thanks again.

Submitted by Anonymous on Sat, 01/12/2002 - 6:22 AM

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Imagine if you were in a class being taught in a foreign language, even one knew, but had trouble keeping up with. Do you think you might have more trouble paying attention… and quietly tune out? Especially with a teacher who talked fast…

Speed can be really important — kiddos like this who manage to get good study skills sometimes do better in college when they can do things like tape lectures or borrow someone else’s notes (or have an official notetaker as an accommodation). Perhaps not on the college debate team, though :)

Submitted by Anonymous on Thu, 01/17/2002 - 4:10 AM

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I am a PACE tutor and every child who has been diagonosed with ADD (that I have tested) actually has problems processing auditory input. Some frequencies (sounds) can cause the child to appear ADD because these sounds bother the child. I have the kids I do PACE with do The Listening Program in conjunction with PACE and the ADD and CAPD symptoms become much less pronounced.

MEP

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