View Full Version : Hello. Need advice


InterestedInPsy
01-02-17, 04:51 AM
Greetings. I have posted about this in different forums, but never seem to get a straight answer.

I mainly am unsure about something.

Of course, none of you can say anything official. But my main confusion is with if this is considered AD/HD PI or just what I'm also diagnosed with, a LD. The main reason I ask is that the LD criteria is different here in at least Ontario, Canada. Some psychologist will use their code for LD, which is that if there is a psychological processing issue, which does include memory, attention, executive functions, and there is a few other criteria items like functioning, how it impacts you, etc., then how is it different than ADD - PI?

Much of the DSM criteria is based off of executive function impairments, and not attention issues (I'd say 6 of the 9 criteria is executive function issues), then how can one differentiate? I was told I have working memory, self-monitoring, possible emotional control (was mentioned once and that's it), and cognitive flexibility issues, along with some others things that don't relate to executive functions, but to other parts of the LD criteria like fine motor skills. Working memory alone counts for at least 2 of the criteria such as forgetfulness and losing things, which is me 100%. I also have poor self-monitoring skills, in the sense that I make careless mistakes (another thing in the criteria). It was also mentioned that I may not follow through on multi-stepped tasks because I may (and usually do) forget them.

Some other things that I believe I have problems with is being distracted by extraneous stimuli, and problems starting tasks that require effort. Some times I wondered if the last two are in "normal" range for teens. I tend to start studying or projects the night before a test or due date. I get it done with a limited amount of sleep. But it may be a teen thing. Normally, I tell myself I'll do it at a particular time, and as soon as it's the next minute and I haven't prepared to start it, I'll say I'll start later. For being distracted, fan noises, heaters, TV, talking, all distract me. I don't consider my music though distracting when studying or doing homework though.

This may sound like I already know or trying to "label" myself, but mainly want to see other treatment options. If it's an LD, then there is pretty much only accommodations that can be made. If it's AD/HD of some form, there are other treatment options (medication, therapy, coach, etc..) other than just accommodations. Much of this is stated based off a neuropsychological assessment I got least than a year ago. It also said I had some sustained attention problems, but not in clinical range. I also have a lot of co-morbid conditions I'm 99.9% are properly diagnosed (anxiety and ASD), but the LD has confused me. Also, I meant to say the co-morbid conditions do mimic AD/HD too.

I hope you don't think of this as seeking attention. I only want to make sure I'm doing everything I can to do better. A lot of my problem is I work on my homework too slowly for the amount of hours in the day. I have what feels like an endless amount of stuff to do with little time. I'm not even motivated to start it in a reasonable faction.

One thing is I'm unsure if my symptoms presented before age 12. My carelessness did for sure. I don't remember a lot of my younger days (before 12). But I qualify to have a LD...

Tl;Dr
Difference between LD related to the psychological processes of attention, memory, and executive functions. I personally have problems with working memory, self-monitoring (carelessness), cognitive flexibility, and emotional control (though wasn't really talked about). Sustained attention was reported as some problems, but not in clinical range.

I also feel I have problems with starting a task, and extraneous stimuli.

I know I have anxiety and ASD. I am questioning my LD due to above.

Thank you for any advice.

sarahsweets
01-02-17, 08:24 AM
Much of the DSM criteria is based off of executive function impairments, and not attention issues (I'd say 6 of the 9 criteria is executive function issues), then how can one differentiate? I was told I have working memory, self-monitoring, possible emotional control (was mentioned once and that's it), and cognitive flexibility issues, along with some others things that don't relate to executive functions, but to other parts of the LD criteria like fine motor skills. Working memory alone counts for at least 2 of the criteria such as forgetfulness and losing things, which is me 100%. I also have poor self-monitoring skills, in the sense that I make careless mistakes (another thing in the criteria). It was also mentioned that I may not follow through on multi-stepped tasks because I may (and usually do) forget them.

By LD do you mean learning disorder?


I hope you don't think of this as seeking attention. I only want to make sure I'm doing everything I can to do better. A lot of my problem is I work on my homework too slowly for the amount of hours in the day. I have what feels like an endless amount of stuff to do with little time. I'm not even motivated to start it in a reasonable faction.

One thing is I'm unsure if my symptoms presented before age 12. My carelessness did for sure. I don't remember a lot of my younger days (before 12). But I qualify to have a LD...

I dont think you are attention seeking, you just want some help.

InterestedInPsy
01-02-17, 03:40 PM
By LD do you mean learning disorder?


I dont think you are attention seeking, you just want some help.

Yes, by LD, I mean learning disability. I didn't read where you're from, but I know learning disability means two different things depending where you are from. When I say learning disability, I mean what they call in the UK a learning difficulty. I am also saying this for other members as well. I have an above average IQ.

I don't say SLD because I was diagnosed with a learning disability that isn't specific, because of the criteria set out by my province, Ontario.

I just need some guidance, thanks.

Pilgrim
01-03-17, 11:10 AM
Maybe I'm a tired but what learning disability are you referring to.

It's hard to give ideas cause really there's not enough detail.

Just a thought, I think I get where your going with this, find a dr who specialises in ADD, it gets complicated.

Approach them and have a list of questions, I guess if it's feasible.

If your looking for treatment this will be your first call anyway.

GoalieMel33
01-03-17, 12:39 PM
I could be wrong but it looks to me that ADHD difficulties present in a more varied context. Sometimes socially or emotionnally for example instead of exclusively cognitive (like in a LD).

I guess it would be hard to tell whether someone has ADHD or not solemnly based on their neuropsychological profile. Because each person has different strengths and weknesses although there are common struggles (diversed in severity).

Another issue as you mentioned is the presence of comorbities who share similar symptoms.

There is help though. Before I got diagnosed, I still had access to accomodations (the same that were recommended for ADHD), I received support from a special ed educator on studying/learning skills, occupational therapist for art therapy and employment counselor.

Knowing what you have a hard time with (with your report in hand too) might make it easier to receive help, whether you have a diagnosis or not. The ADHD medication route might not be available in your current situation but I'd say there's nothing wrong with seeking a 2nd opinion if you think it might be useful.

InterestedInPsy
01-04-17, 02:32 AM
Maybe I'm a tired but what learning disability are you referring to.

It's hard to give ideas cause really there's not enough detail.

Just a thought, I think I get where your going with this, find a dr who specialises in ADD, it gets complicated.

Approach them and have a list of questions, I guess if it's feasible.

If your looking for treatment this will be your first call anyway.

I'm referring to this one:
http://http://www.ldao.ca/wp-content/uploads/LDAO-Recommended-Practices-for-Assessment-Diagnosis-Documentation-of-LDs1.pdf (http://www.ldao.ca/wp-content/uploads/LDAO-Recommended-Practices-for-Assessment-Diagnosis-Documentation-of-LDs1.pdf)

That is the criteria for it above.

I can say that overall, many people I have talked to who are more knowledgeable on the subject than I am (social workers, psychologist, etc.) say that overall, my scores for everything were really high (most range from 50-99). The ones I scored a wide vary was working memory. Overall it's in the 63rd percentile, though. The Digit Span Forward and Backwards were my low scores, with 16th and 9th respectfully. The other part I scored low on in working memory was the D-KEFS was the Design Fluency TRD (total repeated designs) was seeing how many designs were unique. I scored in the 6th percentile I believe (blurry image). The D-KEFS SLE (set loss errors) test I scored in the 0.8th percentile.

I also have a weak immediate visual memory, being in the 12th percentile.

For my fine motor skills, I scored in the 16th percentile, which was tested by NEPSY-II Design Copying Process Motor Score (PMS).

In my report for attention, she only said that I overall did fine, with a few minor mistakes. I don't understand this specific test results, but it was the CPT-II if anyone knows. I did a few others, and overall I scored between 50-75th percentile.

The Conners' 3 filled out by a teacher and my mom said that I had no difficulties in attention or executive function land. My teacher reported problems in peer relations, due to ASD.

The BRIEF-2 was filled out by my mom and teacher, and my mom reported no executive function problems, but my teacher pointed out shift and emotional control. Testing showed weakness in cognitive flexibility that was abstract. So I could switch between numbers and letters, but not two different categories (furniture and fruit was my testing categories). I also had difficulties generating words starting with a specific letter. The tests were part of the D-KEFS. I had problems with self-monitoring in terms of the mistakes I made that was talked about in the working memory part of this (design part, D-KEFS).

My strengths were mainly my processing speed, which was in the 90th percentile. My verbal and performance IQ were not that different (106/65th and 102/55th). My immediate verbal memory was in the 91st percentile. My math IQ was also high being in the 84th percentile. Writing was fine. Reading was average, but lower on reading comprehension compared to my normal on other score (47th).

In my testing, I reported problems with hyperactivity apparently from one of the testing scores. I have problems with sitting still (I need to shake my leg normally) and feeling restless, which the psychologist was said was a cause of anxiety. I also tend to blurt out answers in class, and interrupt others sometimes.

My mom is pretty blind to my problems. I asked my friend to do an AD/HD Test for me, and she scored me in the AD/HD range(s). It was one my psychiatrist gave me I believe to do when I was seeing a psychiatrist. I don't see her anymore. I don't know where this test went.

It probably would be a good idea, though I wouldn't know where to start. A friend I know was diagnosed by her family doctor, a paediatrician. I guess for me, it gets complicated with all my co-morbid conditions.

Hope this helps more. Thank you 😊.

InterestedInPsy
01-04-17, 02:50 AM
I could be wrong but it looks to me that ADHD difficulties present in a more varied context. Sometimes socially or emotionnally for example instead of exclusively cognitive (like in a LD).

I guess it would be hard to tell whether someone has ADHD or not solemnly based on their neuropsychological profile. Because each person has different strengths and weknesses although there are common struggles (diversed in severity).

Another issue as you mentioned is the presence of comorbities who share similar symptoms.

There is help though. Before I got diagnosed, I still had access to accomodations (the same that were recommended for ADHD), I received support from a special ed educator on studying/learning skills, occupational therapist for art therapy and employment counselor.

Knowing what you have a hard time with (with your report in hand too) might make it easier to receive help, whether you have a diagnosis or not. The ADHD medication route might not be available in your current situation but I'd say there's nothing wrong with seeking a 2nd opinion if you think it might be useful.

Hello. Thanks for your response.

That may be a difference. It may be that they find that I don't show problems at areas outside of school because my mom didn't report it. A lot of stuff I noticed in the report was that my mom was needed to be asked in different ways to finally give out the answer. Like, she reported no social problems, but also was concern with my literal language, transition problems, and being able to socialize with same-age peers. So it didn't seem like a concern to ask her about things at home. Like, she reported no working memory problems, but my test scores show working memory problems. My siblings notice my attention problems and hyperactive problems quite well. My sister always gets mad when I shake my leg and she is sitting on the same thing (couch, car seat, etc.). I'm often called deaf by my siblings.

I mentioned in my other post, that my friend filled an AD/HD Test that I believe my old psychiatrist gave me. She says that I often forget things, seem to not paying attention, just thinking and ignoring my surroundings, things typical in AD/HD. These would impact me socially and emotionally. I'm lucky that the friends I have (and choose very specifically) have their own perks (we'll call it that), and understand me and my "issues".

And yes, just in the new DSM-V they allow the co-morbid diagnosis of ASD and AD/HD. They thought you couldn't have both before.

I still have my school accommodations, but that's pretty much it. My mom said that I don't need to go to OT or anything else, since the psychologist said I didn't need anything. But I compare it to someone with pre-diabetes. They don't need to do anything, but not doing anything could mean it gets worse for them (diabetes). It may not be the best example, but you get the point.

In university (this year), I hope to see a learning strategist, do OT, and a few other things to help me.

I probably will probably get a second opinion, but I don't want to pay the same thing, since it costs a lot normally for this. And I won't have that kind of money in school.

Thanks for your advice 😀.

Pilgrim
01-04-17, 04:27 AM
you need to get a second opinion. Don't know if this is possible, but keep mum out of the loop.