NlD/ADD Comorbidity?

When I look at th NLD profile, my daughter has it except she has great social skills. She also has the VLD profile (we got it all).

She is on Concerta. Made a world of difference in all areas. Just our experience. Don’t know if it helps much.

One study of a small number of NLD youngsters (8-12 or so) that I looked at several years ago found that all of them were also ADHD. I suspect executive dysfunction is part of the NLD profile and that often medication helps a good deal. I presently serve two students who have NLD/ADHD profile. Both take Adderal XR with real benefits, benefits the parents see and wish they had followed-up on earlier.

My NLD daughter, now 12 was also dx ADD, mostly inattentive and impulsive, at age 7.5, at same time as NLD dx. Her executive function is in the pits (!!!) and it is our observation that the adderall (now 40 mg adderall XR daily) makes a difference in her ability to organize her thinking, functioning, etc. At her second major eval, at age 10.5, her VIQ had jumped a lot, showing a much bigger split between VIQ and PIQ, and psychologist attributed this in part to the meds (which she was not on at time of first eval). Also attributed in part to years of therapy and tutors.

I know that executive function is a problem for lots of ADD/ADHD kids (the old frontal lobe weakness) and I suspect for many NLD kids.

So yes, the 2 dx can (and often do, from what I’ve seen) come together. If you think the ADD possibly interferes, it might be worth a try on meds, most of us know pretty quickly if they are helping or not.

My son had been diagnosed with both. He takes Methylin and Wellbutrin. He functions much better with the Methylin (stimulant for inattentive ADHD). I know of other parents who don’t medicate their children, and with the correct environment, they are fine. I think it is a very individual thing. :-)

I checked the board looking for you Margo, I have some questions for you, but I’ll email you off line.

Here’s my current thoughts about this:
We went thru the ADD check list with our psychiatrist that is treating ds for anxiety and keeping an eye on the attention problems and reliance on fantasy. We don’t know which comes first with this kid : is he inattentive b/c he’s anxious,? engaged in too much fantasy b/c he’s inattentive or is it the other way around? So hard to tease out the answers…

But our doctor felt that since he didn’t meet the threshold for a dx of ADD, and is anxious, that medication wasn’t appropriate. We are working on the attention and exec. function more thru therapy right now.

Next year when he’s in a small special school, if the attention is still a problem we’ll reconsider meds. One thing the doctor told us he uses in coming to this decision is to ask: 1) is the child learning (yes) and 2) is he having appropriate social interactions. Despite ds’s deficits in social skills, he does have friends, and is appropriate with his peers.

So I think its a case by case, day by day thing.

Have your child evaluated specifically for ADD and other executive functioning deficits. This evaluation should not be based solely on rating scales- they are only based on what we can observe- not necessarily the child’s actual capacities. For instance, anxiety can easily look like attention deficit. The evaluation should include a continuous performance task via computer which can look at attention, impulsivity, and persistence for both visual and auditory information. There are a number of other tasks- typically given by a neuropsychologist- that are designed to look at these capacities as well. Good luck.