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I have a 6 year old son in first grade who has very recently been diagnosed with mild ADHD - impulsive type. He is also highly gifted.  He has been evaluated by two psychologists with differing opinions.  The first evaluation at age 5 determined giftedness and impulsivity without an ADHD diagnosis. The second evaluation at age 6 stated “mild ADHD”.  The recommendation is to pursue Occupational Therapy and psychotherapy to address anxiety (co-morbid anxiety).  He also has some sensory issues. I’m having a very hard time figuring out what to do. We are moving forward with the OT and psychotherapy as suggested.  A part of me is not convinced of the ADHD when also considering his age, and the question - can it be misdiagnosed given his giftedness and sensory integration issues?.  As of January, we are moving him from a traditional, highly competitive private school to a non-traditional progressive / Montessori style school. My hope is that the change in environment with help alleviate some of his classroom behavior issues (fidgety, expectation to stay in seat for long periods of time and disruptiveness “blurting” during classroom lecture). Does anyone else have experience in a complicated diagnosis factoring giftedness, anxiety, sensory, how to differentiate, etc….?  He is highly visual (right brained) and highly sensitive…to his environment and everything else. Any advice would be appreciated.

Replies

Both my kids are gifted/ADHD. It is more common than you might think. In Canada, ADHD is broken down into three categories, primarily inattentive, combined, and primarily hyper.  My oldest is primarily inattentive and my youngest is combined.  My oldest has big sensory issues (which is also common in gifted kids), as well as anxiety. Apparently also another gifted trait. They have huge imaginations and, as a result, they tend to over-think things.

Both my kids are in gifted classes that are offered through our public school board.  The teachers are well trained on how these kids think and learn. They will be the first ones to tell you that these traits are very common amongst these kids. Believe it or not, learning disabilities in general are also common in these kids.

Posted by ButterflyGirls on Dec 19, 2013 at 12:05am

Be sure to be comfortable with the diagnosis of ADHD before giving him meds (if you decide to do so).  Giftedness and ADHD share many characteristics.  Diagnosis of ADHD is symptomatic. 

A good article I found useful.  http://www.sengifted.org/archives/articles/misdiagnosis-and-dual-diagnosis-of-gifted-children

The Montessori environment will be great for your son.

Posted by Lori250 on Dec 19, 2013 at 4:33pm

I was going to reference the sengifted articles also.

Posted by Dr. Eric on Dec 19, 2013 at 5:53pm

You have described my son exactly when he was 6 years old. ADHD, anxiety and sensory processing disorder were all part of the reason for his academic struggles. We also found that he was officially gifted at that time, something we already knew. He was going a million miles a minute and was overly sensitive.

OT helped him a LOT at that age and I definitely recommend that, especially for the sensory issues. Treating his ADHD effectively has made a world of difference and he’s doing quite well now at age 11. His favorite thing at school is gifted pull-out class—that is the time each week that he feels successful. Find ways to nurture what your son excels at and that will help with self-confidence.

Penny
ADDconnect Moderator & Mom to Tween Boy with ADHD and LDs

Posted by adhdmomma on Dec 19, 2013 at 6:06pm

My son has all of the same things too.  He will be 9 in a couple of weeks and is in 3rd grade.  He is highly gifted and I recommend keeping him where he will get his academic needs met 1st!  That is very hard to come by.  Then you can get a 504 by law if you need special accomodations for his hyperactivity.  My son is in a GATE contained class of about 30 children.  He has about 2-3 other children that are at his level and help him keep interested in learning and competing in math and reading.  He used ot dumb down to be like the other children.  He was angry and very bored before we put him in a GATE contained class.  If you put him where he will not be academically challenged he will be more fidgety, because he is so bored.  My son still blurts out answered because everyone else is just too slow to respond LOL A little ADHD humor.  My son also has ticks.  He is currently chewing holes in his front coller and sleeves.  I jokingly told him I can’t keep buying him new shirts and will have to charge him for the shirts, so he started licking his shoulder instead!!  I even bought him a sensory stick for school, but he can’t find it most of the time because of his ADHD he forgets LOL Hang in there and get lots of support from others that have a boy just like yours.  It helps : )  God Bless

Posted by NaturalMom on Dec 19, 2013 at 7:07pm

Sounds like we all have very similar kids.  Mine is gifted, inattentive ADHD and every kind of sensitive.  He’s my favorite person on the planet.  He was in a very structured environment for elementary and middle school and did well academically but not socially.  In High School he is in a less structured environment and grades have dropped just a bit but he’s found his social group and is much happier.  If I had to do it over again I would have switched environments sooner to help him find his “tribe” earlier.

Posted by Bethf on Dec 19, 2013 at 10:08pm

I totally get your concern over how to move forward. My experience has been that my son, who was diagnosed with ADHD and SPD at age 7, continues to benefit greatly from a treatment program of occupational therapy with a sensory integration (SI) approach. We also chose to treat his ADHD/inattentive symptoms with medication. Every child is so different within these categories/umbrella terms, that it’s impossible to say what worked for my son would be beneficial for your child. OT definitely gave me and my son a tool kit to help him function better during daily activities. He’s predominantly a sensory seeker and that appeared as fidgety, noncompliant behavior at school.
It was extremely helpful that our school has an OT that “gets” sensory kids.We also had our private OT meet with the school and his teachers to explain how SPD impacted him, specific to his profile, in the classroom. To this day I’m not sure if my son should be labeled ADHD, but I’ve come to realize that it doesn’t matter, in the end we need to treat the symptoms. Some are SPDish and some are ADHDish. Others are gifted over-excitabilities, anxiety, and difficulty relating to peers that aren’t on the same level as he is academically. Today he’s a happy kid with great friendships and a healthy dislike of school. I’d say the key is creating a team to support your son and educating yourself as much as possible. Posting to this list is a great way to start.
Here are some other resources I found helpful:
http://www.spdfoundation.net
http://www.davidsongifted.org
http://2enewsletter.blogspot.com

Posted by cowboy on Dec 20, 2013 at 5:01am

Thank you all! This has been so helpful and nice to realize that I am I am not living on an island, although it feels like it sometimes!

Posted by jss07 on Dec 23, 2013 at 8:51pm

My son, who is 10 years of age, is similar to your children. He started to show symptoms at 2 1/2. I would recommend NOT putting any of the children on meds. I tried a lot of different stimulants and an antidepressant on my poor child and it was a disaster. The side effects made him so sick. He lost too much weight. He became more aggressive coming off the drug at night. He couldn’t sleep. So what does the doctor do? Give him another medication to get him to sleep. He developed tics from the drug Vyvanse that were horrible.

This past summer, I worked with a doctor to pull him off all drugs. He started a gluten free diet and he is now going to a doctor who specializes in vitamins and biofeedback. He looks much better. He is healthier. We still have issues of going to sleep at night but he’s not sick.

These children need intensive therapy -socialization, OT and life skill classes. A great school/camp in New Hampshire called The Hunter School focuses on gifted children with issues. The Orion School, unfortunately now closed, I heard was wonderful. These children can grow up and be successful if they get the right help. The public schools do not know what to do with gifted kids with issues. My son sat in the principles office half the year. The public schools are making huge mistakes placing these children in special ed classes and not giving them the proper help. Shame on them! Doctors too! All we were told for years is that our son is complicated. Our son has a high IQ with ADHD and anxiety and falls into a category where schools and doctors don’t know what to do with them. Thank God for parents who are opening schools, writing blogs and finding ways to help our children properly.

Posted by advocate50 on Dec 29, 2013 at 9:27pm

I’ve been told it’s a fine line between giftedness and adhd. They have some of the same problems. Potential Plus Uk say that giftedness (they call it high learning potential or hlp) should be treated as a special need. Your son should have his needs met to fulfil his potential in class whatever the label. My daughter is in the same situation age 9.

Posted by Janeybee on Mar 19, 2014 at 6:25pm

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