Janis--

Hi, Suzi!

Yes, of course, I remember you! Everytime I see something about Shelton I wonder how your daughter likes school this year!

Well, I don’t think there is a clear cut answer to your question, unfortunately. I think I might personally try a neurologist first as I am not overly impressed with the psychiatrists I have dealt with regarding one of my own children, but I understand the concern regarding anxiety and depression.

I think just like with APD, the key would be to find someone who actually specializes in ADD/ADHD as opposed to a regular general psychiatrist who just does it occasionally. It is ironic, but I just ordered and received Dr. Daniel Amen’s book “Healing ADD”, but I haven’t read it yet.
I’m thinking that reading something like that may help prepare you to choose a doctor better and also be more familiar with possible drug choices before you go. Have you checked your local CHADD chapter for a list of references? It just may take some phone calls to find a good match.

In any event, whoever you go to will surely give you and your husband and her teachers a checklist to fill out to get an idea of behaviors you have all observed. I imagine the Shelton staff is very accurate when they suspect ADD, though. I think I would also make some phone calls requesting information as to whether the doctors have knowledge of APD and are able to separate the symptoms of the two disorders. You might get doctors who know nothing at all about APD, and I agree that would be a mistake. The social worker may not be experienced in APD either, so I think I’d skip that step.

One interesting thing would be to repeat APD testing after she is stablized on medication (if you try it). You might get better performance on some of those tests.

Let me know what happens! And sorry not to be of more help!
Janis

Are they mutually exclusive? I would bet not. I am working with a kid dxed as CAPD, and I am pretty sure she is ADD as well, and I haven’t changed my mind on the CAPD thing.

—des

How many times have I been saying that CAPD/ADD can be co-morbid? I have both, and 3 of my kids have both CAPD and ADD. For YEARS I thought my daughter’s learning differences were only due to CAPD and the CAPD expert I work with who is well known…told me…she thought it was more that just CAPD as she was so inconsistent in her responses to the auditory tests…..The ADD expert we took her too refused to see her at first because he thought it was CAPD but when he saw the irratic performance he too realized that she was Co-Morbid with both CAPD and ADD. After meds…my daughter said…’mommy, is this what it feels like when you are paying attention….because things make much more sense now..”

I wouldn’t rely on a Social worker to figure out where your daughter’s problems are. There are certain things that stand out for kids with CAPD/ADD co-morbidity…and one of them is processing speed, and the kids are on and off when they are trying to pay attention.

If your child is struggling at Sheldon, that is sending me a big RED flag that she has more going on than just CAPD. I heard the founder of the Sheldon school talk once, and she seemed very saavy..

As a speech professional, I have learned to distinguish kids with CAPD/ADD but probably because I have it too. It never ceases to amaze mefor a kid who has been a puzzle for people to figure out…underlying the problem was co-morbidy between many issues not just the one..

Sometimes as parents it takes us a while to have the courage to face what we don’t want to see. That happened to me..I wasted 2 more years denying my daughter’s attention issues thinking it was just CAPD…I am kicking myself now…wishing I had done something in 3rd grade instead of waiting until she was in 5th grade and failing…

I don’t have it, Patti, but the kid I have has been dxed as CAPD. But there are things the CAPD doesn’t explain, imo. A certain wiggliness, very difficult to keep focused even one on one, and she is very very competitive. If we play a game it has to be for points or she isn’t playing. I manage ok in a tutor situation. but I can’t imagine how this kid is doing at all well in school. But be sheer raw intelligence.

If the kid being discussed here has both would explain a lot of stuff!

—des

The co-morbidity usually comes out when things just don’t add up to one nice little package…The things you are talking about sound kind of ADHD to me…the wiggles, the competition…it just doesn’t add up to a kid with CAPD only…

Me too Patti! I am pretty well positive the kid is not straight CAPD. Those things sound to me like ADHD as well. I have no idea why these things aren’t dxed as separate things. Really figuring out the ADHD part has helped me deal with her. Not sure if I should mention this to her mom, and if so how??

Another pet peeve of mine is autism spectrum and ADHD. I think they are separate things. Whilst :-) people in England agree, people here do not.
They think that if you are autistic it just means you will have these characteristics, but it sure does not explain those who don’t. Imo, the kids with ADHD characteristics are trickier customers all the way around.

—des

My son had the wiggles in class and even had them one on one with certain teachers. I had more than a few teachers imply he needed meds.

He doesn’t have the wiggles anymore after interactive metronome. So is he ADD or not. I still don’t know. Vision therapy addressed other deficits that had him looking very adhd. He is the best jump roper in the class and his self esteem is soaring because of his new found physical skills. I do know that if you address underlying deficits you may be able to avoid meds.

There is nothing to indicate that he would need meds now. He is an avid reader and is doing super well in math after struggling despertately with it for years. The only thing left is a little inconsistancy which now is usually related to something like being tired or hungry. He also does not write or spell as well as I would like but the teacher doesn’t see it as a major issue. Before, he was inconsistant in 20 different ways that I could not pin point.
I have a good handle on his remaining deficits and think I know the strategies to address them.
Most doctors are not aware of these strategies. These truely are things only a parent can do. IMO.

<<Another pet peeve of mine is autism spectrum and ADHD. I think they are separate things. Whilst :-) people in England agree, people here do not.
They think that if you are autistic it just means you will have these characteristics, but it sure does not explain those who don’t. Imo, the kids with ADHD characteristics are trickier customers all the way around.>>

Des,

I knew there was a reason I liked you<g> as you keep hitting themes that are so near and dear to me. People also think that NLD and ADHD can’t co-exist which I think is just not accurate. Now, until I get an evaluation for CAPD which also might explain my ADHD symptoms, I do admit what I say is speculation.

PattiM, this leads to my next question. How do you distinguish between CAPD and ADHD since you have alot of personal experience with it? I know you can’t diagnose me but because of my own situation, I am curious.

I can listen to an audiobook for example and it seems like it goes in one ear and out the other even though I am on stimulants. Most people with NLD would remember pretty well what was said.

On a test for receptive language impairments, I wasn’t on any medication and couldn’t remember anything that was said. Later, on a neuropsych test, I did well on an oral passage although I got the gist better than I did the details and was on medication.
But because the guy told me ahead of time I was going to have to summarize the story and answer questions, I think I hyperfocused.

Anyway, I think you do a real disservice to people when you say that conditions can’t co-exist. I have some additional impairments that definitely aren’t explained by NLD so I am living proof.

Thanks

PT

[quote=”Linda F.”]My son had the wiggles in class and even had them one on one with certain teachers. I had more than a few teachers imply he needed meds.

He doesn’t have the wiggles anymore after interactive metronome. So is he ADD or not. I still don’t know. Vision therapy addressed other deficits that had him looking very adhd. He is the best jump roper in the class and his self esteem is soaring because of his new found physical skills. I do know that if you address underlying deficits you may be able to avoid meds.

There is nothing to indicate that he would need meds now. He is an avid reader and is doing super well in math after struggling despertately with it for years. The only thing left is a little inconsistancy which now is usually related to something like being tired or hungry. He also does not write or spell as well as I would like but the teacher doesn’t see it as a major issue. Before, he was inconsistant in 20 different ways that I could not pin point.
I have a good handle on his remaining deficits and think I know the strategies to address them.
Most doctors are not aware of these strategies. These truely are things only a parent can do. IMO.[/quote]

Its hard to say for sure, but it may be that your child had developmental delays in visual processing that responded to the vision therapy rather than true ADHD. I may be wrong about this, but my understanding is that vision therapists don’t claim to treat ADHD, they only treat developmental visual issues that masquerade as the disorder. whatever it is, I am glad your child is doing so well.

Des,

>I knew there was a reason I liked you<g> as you keep hitting themes that

well (blushing) gee, thanks. :-)

>are so near and dear to me. People also think that NLD and ADHD can’t co-exist which I think is just not accurate. Now, until I get an evaluation for CAPD which also might explain my ADHD symptoms, I do admit what I say is speculation.

Well speculation maybe, but imo, NLD (as well as AS) can go with ADHD. I suppose the incidence of ADHD is so high on the autism spectrum that that’s why it isn’t labeled as different. Also there are some ADD traits that are signature pretty much of AS, ie hyperfocus. And if you don’t hyperfocus they’ve given the wrong dx. OTOH, I think Lorna Wing (British autism expert) says they are separate. Good enough for me.

Don’t know particularly about NLD and some of these traits.

And I suppose you could have all three (CAPD, NLD and ADD).
I suppose at some point you have to think, what is helping you know about and what is not. I mean if it helps explain things…

>I can listen to an audiobook for example and it seems like it goes in one ear and out the other even though I am on stimulants. Most people with NLD would remember pretty well what was said.

Yes that’s so. OTOH, people with AS aren’t so good at that. It isn’t that they don’t understand, hear, but I think we are somewhat caught up in over details and not really relating to people situations so well (like what would be in fiction).

>On a test for receptive language impairments, I wasn’t on any medication and couldn’t remember anything that was said. Later, on a neuropsych test, I did well on an oral passage although I got the gist better than I did the details and was on medication.
But because the guy told me ahead of time I was going to have to >summarize the story and answer questions, I think I hyperfocused.

Yes, perhaps similar to what I said people with AS tend to do. Listening for details.

—des

Each person is different and each situation is different. I have a hard time with auditory information without visually seeing it. It is all CAPD related, however I studied for classes by listening to auditory tapes to train my auditory memory and I did better on exams after that. I can also tune out when I am overwhelmed and tired from listening.

It is really hard to tear CAPD/ADD apart because they are so co-morbid. But where I think the rubber really hits the road is seeing how the person performs while doing an auditory continous vigilance test. People will make certain types of error if they are ADD rather than CAPD.

I was talking to a mom the other day about her child and the more I listened to her the more I realized it could be more than just the language piece. I told her to check out langauge, vision, cognition, the whole gamut because I would rather test it all without leaving things to chance. However, I think I overwhelmed her by giving her too many variables to rule out…:-C

Pattim,

Who would give a continuous auditory viligence test? I had thought such a test would not be valid, if a child had CAPD, so have never pursued it. My son was diagnosed as ADD-inattentive by a neurologist but it seemed to me like it was almost a done deal. I mean he looked at the forms by the school and us and asked lots of questions. He said children with severe learning disabilities are almost always ADD.

We did Interactive Metronome and afterwards his teachers no longer rated him as inattentive. I still see it sometimes though and wonder. Of course, working with me on homework and thinking about other things could just be the good old procrastination method. In school, I am told he is on task and hard working. However, he has told me things that make me wonder like he can get his work done best when he knows recess is next.

Beth

Des,

<<Well speculation maybe, but imo, NLD (as well as AS) can go with ADHD. I suppose the incidence of ADHD is so high on the autism spectrum that that’s why it isn’t labeled as different. Also there are some ADD traits that are signature pretty much of AS, ie hyperfocus. And if you don’t hyperfocus they’ve given the wrong dx. OTOH, I think Lorna Wing (British autism expert) says they are separate. Good enough for me. >>

I think you hit the nail on the head. Yeah, many NLDers may have inattention problems but that’s because of the visual issues, which are particular to NLD usually. I am unusual since I also have audio issues.

<<I suppose at some point you have to think, what is helping you know about and what is not. I mean if it helps explain things…>>

Good point. Even if I were to get an evaluation explaining every last mystery tomorrow, is it going to solve my unemployment problems? NO!

But I still have this need to know. Can’t explain it.

<<Yes that’s so. OTOH, people with AS aren’t so good at that. It isn’t that they don’t understand, hear, but I think we are somewhat caught up in over details and not really relating to people situations so well (like what would be in fiction).>>

I don’t think that’s it for me. Even when I make a point to listen for the main ideas and not focus on the details, I still forget everthing.

>On a test for receptive language impairments, I wasn’t on any medication and couldn’t remember anything that was said. Later, on a neuropsych test, I did well on an oral passage although I got the gist better than I did the details and was on medication.
But because the guy told me ahead of time I was going to have to >summarize the story and answer questions, I think I hyperfocused.>>

<<Yes, perhaps similar to what I said people with AS tend to do. Listening for details. >>

According to the neuropsych, I got the gist better than I did the details.

PT

<<Each person is different and each situation is different. I have a hard time with auditory information without visually seeing it. >>

Same here.

<<It is all CAPD related, however I studied for classes by listening to auditory tapes to train my auditory memory and I did better on exams after that. I can also tune out when I am overwhelmed and tired from listening. >>

Congratulations. Interestingly, many years ago, when I taped lectures and strictly listened to them, I did alot better on the material. But for new material, I think I am a multisensory learner.

<<It is really hard to tear CAPD/ADD apart because they are so co-morbid. But where I think the rubber really hits the road is seeing how the person performs while doing an auditory continous vigilance test. People will make certain types of error if they are ADD rather than CAPD.>>

I can imagine it would be. I’ll keep that test in mind when I finally do get a CAPD evaluation.

<<However, I think I overwhelmed her by giving her too many variables to rule out…:>>

Hopefully, she will follow your advice.

Thanks Patti!

PT

My child has both CAPD and inattentive ADD. The neuropscyh supected the ADD because because he did not do as well on some testing that he should have aced. His mind just seemed to wander even in the 1:1 situation. We tried meds and he instantly could attune better to what was being said. He could multi-task, which was also a new behjvior demonstrated on the first day of meds.

I also wonder when I read threads like this ( and when I try to sort out what the cause of my son’s problematic behaviors are) if sometimes there just isn’t an answer. Like pattim said, there are puzzling kids who have co-morbid disorders. I have an inattentive child - is it ADD, is it anxiety, its so hard to know. I’ve come around to LindaF’s view that sometimes you just have to work on the deficits and then sometimes the root cause does become clearer.

An intereresting opinion is on the Schwablearning site—search on ADD and Russell Barkley Phd who sees language-based learning disability as a skill defict and ADD as a performance defict. Although many on these boards post and lump language-based LD and the solutions for that with NVLD/AS/executive function problems, I think that the later are the group much harder to remediate.

Karen,

Ironically, our oldest child, a son, was not LD, but he definitely had issues with focus and anxiety. We never have been able to sort out what is really wrong with him after going to multiple doctors. I have really decided that doctors don’t know all that much. I think we a parents see so much more of a child’s behaviors than a doctor ever could.

Our child with APD has some language delay, but she has no ADD or other disorders to my knowledge. I think it is common for kids to have co-mormid issues, however.

Janis