Where do we go from here???

His processing speed on an IQ test is very good, but due to the NOVELTY of the IQ test he was able to focus and show what he knows…But the reality is he can’t control his mind in the classroom because of too many things going on. He gets overwhelmed and then gives up which he has been doing for sometime. My daughter did the same thing…and by 5th grade she had given up and that was when I finally got her help for her ADD. Kids like your son and my daughter that are ADD-Inattentive are usually the ones that are easily overlooked because they are typically good kids in the classroom, they take forever to do their work becuase they are too focused on everything else except for what they need to do and they don’t even know where to start sometimes…

One of my close friends whose son was a really slow methodical processor and had a hard time with reading… I worked with him one summer and I pinpointed what his problem was…when I was working with him and my daughter on their reading, writing. I noticed he would get distracted if the computer screensaver came on, he would listen to what I was saying to my daughter and his reading was either on or off. One day I looked at him and said…”Where did you go? when he was trying to give me his attention but I could tell he was GONE. He looked at me and said…How did you know?

I looked at him and said…”you are talking to a master of this…I can spot it a mile away…and he said…”I don’t know how to stop it…my mind just goes off somewhere all the time…Just now I was imagining I was down the street playing hockey at the elementary school. I knew then and there we we dealing with ADD-Inattentive.

I recommended he be seen by a Dr. which then put him on a trial of meds. What a difference it made for him in his readnig, schoolwork, concentration, homework etc.. Then in about 6 months…The mom took him into a psychologist who tested him. His IQ was in the gifted range and the psychologist said he didn’t think he had ADD and to take him off meds.. They took him off the meds and the child took a huge tailspin…

Again…he could hyperfocus for the IQ tests with the psychologist because they were a novelty but he couldn’t hold it together in the classroom. The mom brought him back into the psychologist and he said…”Put him back on meds…I made a mistake…” Three years later…He is now on the honor roll and doing really well.

Once you get his Vision squared away and you get him on the proper medication you will notice an improvement in his attention, schoolwork and his penmanship. I have been down this road with many kids…He will make it as he is smart, he just needs some help in organization and learning how to focus… Ask him sometime where he goes when you see him in that ZONE…you may be in for a surprise…

Good luck!

I suppose if you believe there was no problem you would not post that message :

But going back to facts:

I do not know what state are you in, but generally the discrepancy between potential and achievement is defined as a “1 and a half” (in some states only one) standard deviation difference between the two scores. With your son IQ of 117 that means that any standard score below 95 (117-22 if your state is using 1.5 SD difference) is a result that should generate concern.

From what you have posted the broad reading from WJ-R at 89 are 28 points below his IQ; similarly, results from WIAT the results foe numerical operation and spelling are depressed when compared to his potential.

Do I read this correctly that in the Rey Osterrieth Complex Figure Test he tested in the 10th %-ile? If so, this is a BIG RED FLAG for visual-motor interagtion.

What did the private tester say?

Ewa

I gave you a long reply to this on another board (reading? teaching ld?)

patti–

I know exactly what you’re talking about…I could have a five minute (one sided albeit) conversation with him and ask him to repeat what I said and he can’t, even though he was looking at me the entire time. We did try Strattera back in the beginning of this year, but it didn’t seem to do anything but make him very mopey (didn’t want to anything, including play video games which is highly unlike him) and not eat. I hate to use the stimulants as he is not hyper at all, except the usual kid stuff. And he is a very anxious child, worries about everything and is hyper-sensitive which seem to be common side effects of the popular ADD meds. I can’t imagine either of these traits being exacerbated in him…he’d never leave the house.

Every year I hear the same thing at the P/T conferences..”he’s such a good kid, never causes any problems BUT he is a daydreamer”. His 2nd grade teacher said she could be doing jumping jacks singing at the top of her lungs and he wouldn’t even notice. However, when asked questions in class he always knows the answer. It’s very confusing :?

Ewa—

The psychologist that tested him didn’t comment at all on the Rey-Osterreith test and yes you did read right all three scores are in the 10th% range. I didn’t even know what that meant. I assumed that since he didn’t comment on it in his report it wasn’t significant. I’ve been trying to do a search to understand the different tests he was given, other than WJ-R, WISC, WAIT.

Wouldn’t his score on the Developmental Test of Visual Integration put him in the higher range?? (SS=114, 82nd %, AE=10-3)

I don’t know what the difference is between these 2 tests.

As for the state, we’re in MA. And I beleive that it would be the 1.5 SD difference. I specifically commented on his Broad Reading score during our last meeting and the psychologist doesn’t seem to be concerned. He agrees that there is a deficiency but states he doesn’t qualify for help (a 504 plan is all his teacher and I are asking for) as he is progressing in school. Although I don’t see much progression from K through present. I also can’t see how the psychologist can say he’s progressing as he only met my son once at the end of last school year. In fact his 2nd grade teacher wanted to retain him and the psychologist knew this. How is he making progress when he would have been retained had I allowed it???

Could you explain the R-O test?? I can’t seem to find any info on this one on the internet. Maybe this would clarify some of his problems for me.

Thanks to you both… :wink:

My son looked a lot like a kid with adhd before we did the therapy that got his visual motor integration skills under control.

Interactive metronome, vision therapy and some OT at school did it for him.

One thing that stood out about my son that made me believe that it might not be adhd was that he was inattentive in some ways but he always seemed to remember everything the teacher said. He grasped concepts easily but would fall apart on paper.

Writing and reading are much better but he will still sometimes make mistakes on easy things like punctuation. He still reads directions too quickly and makes mistakes because he does the wrong thing. He may be a little adhd in some small ways. We still have more vision therapy so maybe things will continue to improve.

One other thing I never mentioned to anyone here before. This will sound strange but my son’s face has changed. He always had a crooked smile and in some pictures his eye would drift. He now has a really nice smile in pictures and his eyes are perfectly straight and even. I never thought there was anything wrong with his face before but I just see a change.

I know that sounds weird but it is true.

I think part of the anxiety is related to the ADD. He is overwhelmed and trying to keep it together. It takes every ounce of enegy he has to do so and that causes the anxiety.

How long did he try Strattera? My son’s tried Strattera and it was a bust but it might have been because one was used Adderall and we didn’t give Strattera enough time. One of my son’s was mopey and tired while using Strattera and we did it during the school year and his grades plummeted. The other one is in college and he was nauseated 24/7 and he wasn’t consistent in taking it.

Both my sons are the most laid back kids you would ever meet. They are gifted but without meds they felt like failures as they couldn’t harness their brain. Prior to meds my artistic kiddo’s would zone during class 24/7 they would draw all over their papers, they would procrastinate, miss assignments and get by with A’s in their favorite subjects, B’s and C’s.

Ironically the stimulants allow a person who is ADD-Inattentive to harness their brain and the potential that is within. Otherwise, they will continue to spiral downward frustrated because they know they are SMART but for the life of them they CAN”T pull it together. For instance my son dropped out of Chemistry in High School, he couldn’t focus on it. His first year of college he was on Academic Probation, we put him on meds his 2nd year and now he is out of the doghouse and in a pre-med program. Now he loves Chemistry and tutors Chemistry in College. :shock:

Perhaps Zoloft, may work for your son I have seen this help some kids who are ADD-Inattentive and have anxiety at the same time. This is what concerns me about your son is that he only knows the way his brain is working now, the signs of frustration are there, things are overwhelming and he is giving up.

Yes, Vision Therapy will be a blessing but that doesn’t have anything to do with when his brain takes an ADD-Inattentive vacation… He has to learn to control where his mind goes. The best analogy I can think of is that it is like living in a fog shrouded world and the meds help make it crystal clear.

I had 2 eye surgeries and years of vision therapy as a child, and I am still ADD, VT didn’t fix that one iota.

I don’t want your son to go through what my son’s went through… :oops: I knew my youngest was ADD in 3rd grade…I didn’t do anything about it until he was in 9th grade…He always just squeaked by because he wasn’t engaged…Yes, he was gifted but he didn’t really start clicking until we put him on meds… His freshman year he was overwhelmed and just failing…that was when I thought…Ok, I give in…lets finally try meds…I wished I had done it sooner… :cry:

In High School he has taken mostly AP classes, without meds he would have never been able to do this… Last night he was so proud to announce that he did really well on his AP Calculus test…He earned it!
:lol:

Linda F.—
My son does the same thing with directions. It’s as if he reads the whole set, but only follows one part of them.
As for the ADD, he also has a firm grasp on anything related to Science, Social Studies, Geography, Art, computers, etc. But the traditional school subjects reading, writing and math are lost on him. I truly do not get it :?

I think that the “new” vision problem just adds to the confusion. Is it his vision? Is it ADD? Is it a learning disablility? Is it all of the above???

I really hate to have the wrong answer. The longer it takes to figure out the worse it seems to get. :(

patti—
Actually he was on Zoloft during the first half of Kindergarten due to extreme separation anxiety, he would cry every morning, his teacher and I would actually have to pry his hands off the door jamb of the classroom some days—he was fine as soon as I’d leave though…I’d hate to see if I had been working during this time. Or did my staying home only make it worse? Oh the questions we have to ask ourselves. But anyway…this DID NOT work for him, he became very aggressive and angry which is not his nature.

We tried Straterra for about 6 weeks during the middle of 2nd grade. I couldn’t see keeping him on it longer as it didn’t seem to be doing anything for him other than the previously noted behaviors.

I am going to talk to his Dr. about perhaps trying a[i] low[/i] dose med, after a few weeks of VT just to rule that out as the main problem. It’s just that the more I read about them the more nervous I get trying them. This would probably happen with every medication know to man though, if we only knew what every side-effect was for every medication : ) I’m just nervous about giving him something that could mess him up permenantly as I’ve read about some of the horror stories regarding stimulants. :(

If your tester did not give you comments to these results I would probably go somewhere to have another psychologist look at them. It is quite big set of results which should “speak” for itself.

My understanding is however, that for test like R-O complex figure drawing, there should be comments from psychologist about your son approach to this problem which are helpful in tapping on what was actually his biggest problem (that he did not remember, or his approach to copying was poor, or his attention to the entire task was not really good).

What I know is that you are shown a complex drawing and after some time one has to draw the sample figure from memory.

“…The Rey-Osterrieth Complex Figure (ROCF) is a widely used neuropsychological tool for the assessment of visuospatial processing, memory, and executive function in clinical populations…”

“…The Rey-Osterrieth Complex Figure Test is a task that requires the subject to copy a complex design and later reproduce it from memory; it taps ability to plan, organize, and assemble complex material and is a sensitive measure of the kinds of difficulties experienced by many people with ADHD….” (it is usually referred as executive functioning).

If you have power point, I think this is very informative:

www.utsc.utoronto.ca/~zcampbell/Archive/ PsychC31%20-%20Chapter%2014%20-%20Construction.ppt

I believe that any child that has above average IQ and is performing at the 10-%-ile on some performance test should be considered as having a specific problem. Do you have results on how your son measured against his peers in K and at the end of second grade?

I would certainly ask (in writing) for a definition of eligibility for sped services in your state. I got a booklet like this from State Dept. of Education and it had a simple table which “linked” an IQ score to whatever the highest broad reading score should be to classify a child as eligible for services. This is all about getting classified, which still does not really address the problem.

For any ADD child working 1:1 is a blessing and certainly the best setting to use the child’s time and effort efficiently. If you can locate a private tutor- I would probably go this route. If the tutor is skilled- your child would more likely benefit much more than from any help the school can offer.

The results for standardized statewide tests will tell you that more likely your son is not performing at the average range and will place him at the “intervention” level, but you would need to wait until you get them.

Sorry for being “scattered”- need to go,

Ewa

My daughter has been on Concerta during the school year and off during the summer for about 4 years now. My son’s have been on Adderall for about 2 years, they haven’t caused any long term problems, they aren’t addicted. Using this medication has helped them realize their potential and be successful.

Yes your DS could have co-morbidity with integration of his vision and attentional issues. But when you have a kid who can hyper focus on what he is interested in (He can hyperfocus on video games…which can cause eye strain..but he enjoys the novelty and excitement of video games)
and tune out on things he isn’t interested in that is more of an attention issue.

Yes, he has problems with visual integration, but when his attention is zoning in and out that is a big indicator of how his brain is working. The frontal lobes of the brain is where the conductor of the brain resides and manages our ability to attend to stimuli, to help us plan and organize what we are going to do and stay on task, the occiptal lobe or back of our brain is where vision takes place.

One can try adderall at 5 mg. I have heard that Concerta comes in a smaller dosage than what my daughter started out with which was 18mg. Another one that I have heard that has had positive effects is Focalin.

Don’t discount the right medication, it can make all the difference in the world.

Visual motor integration problems affect more than the occipital lobes.

A child who is struggling with these skills will look a lot like a child with adhd because it is almost impossible to focus your attention on something when the input is no functioning properly. It is much more complex than saying it is all the frontal lobes.

You use various areas of your brain together for even simple tasks. Without integration there is nothing to do but zone out from the world.

My son does not zone out on most things. It has gone from being an everyday type of thing to a problem only when he is facing very difficult tasks.
He used to zone just getting dressed in the morning. Now he is way ahead of most his age. He gets up in the morning and cooks pancakes for the whole family without any help, sits at the piano for long periods, remembers the day he needs to bring his sax to school, organizes his room without being asked.

These tasks require a brain that functions well on many levels.

Gee, all I ask is that he can pick up his room : )

But, on a more serious note…I am going to get in touch with the private psychologist who tested him this past summer and get his input on the Rey-Osterreith results. To be honest I probably wouldn’t have thought it was a visual problem if it wasn’t for the opthamologist visit. I figured that he would have put it in the evaluation had it been a possible issue.

I’m still working with him on his organizational issues though and I think that is helping somewhat. He needs structure, however it has to be imposed upon him. I think sometimes thats it’s as though he lacks the power to regulate himself in things like cleaning his room, picking up after himself, homework, etc. Which is partially my fault, I tend to cater to him which is a bad, bad thing : ( So we are trying out a strict schedule this year for school days and hopefully will extend it into the weekend.

Hopefully the glasses and VT will help at least a little. If he’s still having major problems I am leaning a little torward trying meds in very small doses.

Thanks everyone for the quick and informative responses :)

Each child is different but when you put all the puzzle pieces together I see much more than just vision issues as I have lived through depth perception problems, ADD and APD disorders my whole life. I had surgeries, years of eye therapy, corrective lenses and I still have problems with depth perception.

I have stiches in my chin from tripping on uneven pavement as I can’t judge distance when I am walking. :oops: But I am an accomplished artist ; I can create depth in 2 dimensional media but in regards to motor planning and hitting a tennis or baseball…I am out to lunch, I use compensatory strategies such as counting to make sure I don’t swing to early. :lol:

The more I read about his organizational issues the more I am inclined to side with the ADD side of the picture. He can’t regulate his attention consistently and it is interferring in his life and those around him…

I am off my soap box now….

All of our children are different, but I wanted to reply just in case my antecdotal observations are helpful at all.

My son also looks ADD inattentive, has had a history of problems reading/writing (not math or reading comp.) and is disorganized and spacey. He is a dreamer who suffered from anxiety when the learning issues arose.

In the past 18 months we had him do Interactive Metronome (results hard to say) and moved him to a private school for dyslexic children, started VT, and put him in psycho therapy with a psychiatrist that didn’t want to medicate him for either the anxiety or the attentional issues. He was concerned that stimulant meds would make him even more prone to fantasy etc..

As the anxiety has decreased (bc of the therapy and putting him in the right school) his attention has improved. I can’t tell yet if its improved enough – if he can’t focus in a class of 12 , with teachers that actually know how to teach him then we will revisit the medication question. (stay tuned, our first parent teacher conference is next month)

But there is no question that a combination of anxiety and visual processing issues effected many things. As we address those 2 areas eye contact, social skills and attention all seem better.

I think you have to decide for yourself is medication is the appropriate course of action for your child. We felt these other issues required intervention anyway.

This is exactly why this issue is such a dilemma :?

It looks as though he may have many different things going on but we (his Team and I) never seem to hit on the right issue.

As for the meds I think we will wait just a little longer, as there are possible other non-ADD problems.

Well, we picked up his new glasses yesterday and I think this is going to be our next big challenge. He wore them for a total of 40 minutes yesterday :cry: I was hoping he would be able to wear them a little longer, but the prescription is so strong and he hasn’t been “using” that eye for so long it really bothers him.
The good thing though is that he doesn’t mind the cosmetic aspect.

If this doesn’t work, it’s on to plan B (well actually we’re on about plan N right now…so it would really be on to plan O). :wink:

I keep forgetting to “log in” oops.

Processing Speed 94
Visual Processing 96
Broad Reading 89
Reading Skills 98
Reading Comprehension 94
Trial 5 94 34th
Delayed Recall SS=93 32nd%
[b]Rey Osterrieth Complex Figure Test[/b]
Copy 10th % Range
Immediate Recall 10th % Range
Delayed Recall 10th % Range
[b]WIAT SS %ile GE[/b]Word Reading 94 34th 2:1
Numerical Oper. 80 9th 1:5
[b]Composite 91 27th[/b]
Spelling 89 23rd 2:2
Rapid Naming SS=94 35th

#1…..these scores are low to average. (at least from the tests I’ve been in contact with.) The Percentiles and Grade Equivalent (GE) are what you are interested in.

#2….The Glasses may be helpful with some of this…thats just my humble opinion.

#3….If this was my child…I would look into possible “processing” problems. Be is visual or Language/Verbal. Like I said the glasses may alieve some of the issues….but the Recall scores CONCERN ME GREATLY…Glasses will not fix memory problems. (Retention)

Take Care..Good Luck,
LAN :wink:

I know. The strange thing is, is that in reality he seems to remember literally everything. People, place, events…if he doesn’t need to or isn’t being forced to remember it.

I still am waiting for a response about the Rey Osterreith scores from the independent psychologist who tested him. Maybe he can clue me in and give me some ammo for my next “Team” meeting. I truly am getting tired of going to them when nothing ever changes.

Thanks for the input! :)