We finally got our son seen by the neurosurgery department of our local university hospital.

He still has about 3 days of testing left, but the doctor's initial impression is that our son doesn't have ADD. She basically said, "sure, he's a bit of a dreamer, but if his reading and writing were at grade level you wouldn't be in here." [Which is true] No impairment, no disorder, right?

She was basically like, you and his teachers say he doesn't pay attention. But he paid attention today, so the problem must be elsewhere (like he hates reading because he has a reading disorder, so zones out).

I showed them his math work from school, and how he seldom finishes his worksheets, although the problems he does are usually correct. So his mind works a little slower than other kids', I was told.

However, we live in Japan and this was a Japanese doctor (two of them, actually). I had to explain the concepts of "sight words" and phonics to them. This makes me a bit dubious about their ability to diagnose a reading disorder in my son.

Both doctors did seem very knowledgeable and caring, so maybe it is just me. They told me that I seemed to have ADD, and implied that maybe I was projecting onto my son -- which would be ironic, because I only found out about my own probable ADD because I was researching it for my son!

Duh...what sort of examiner is this? If you have a different setting, you get different results. How can they even think that since he was good in a lab, in a one on one setting, that there is no disorder? You measure behaviour in the setting where it is important, and that is why behaviour checklists are necessary. Sounds like they are decades behind in Japan.

CAPP or innattentive subtype ADHD (which has the nickname SCT) would fit what your describing. And please don't tell me that the Innattentive Subtype of ADHD can't be impairing. A good first year Psych student would know more then this person.


This is what Barkley writes about it.

"Now I want to come back to this group that we call Inattentive AD/HD. We used to call them ADD without Hyperactivity. These days some people are just using the term ADD for them. I don’t like that. Part of the problem with using that term is that that was the old term for AD/HD over 10 years ago, so it creates a lot of labeling confusion.

ADD and AD/HD are the same thing. ADD is the earlier, 1987 term—goes all the way back to 1980, in fact, whereas AD/HD is the more recent label.

So let’s talk about this Inattentive type: the kids who come to see us who don’t show problems with hyperactivity, who aren’t impulsive. What do we know about that subtype? We know enough that several of us in the research community have taken to arguing that this is a different disorder. This does not belong in AD/HD. This is not AD/HD. This is a real attention disorder with real information processing deficits, and it has little in common with the other two kinds of AD/HD.

The Hyperactive type of AD/HD and the Combined type of AD/HD are the same disorder. You’re just catching it at different developmental stages. Kids start out with Hyperactivity; the attention deficits come within a few years after that, and then they move into being the Combined type. But these children, on the other hand, are a different story all together. Why do I think this is a different disorder? Why do some of my colleagues agree with it? Why do the rest of my scientific colleagues certainly agree that this is a qualitatively different group of children? Whether you view them as a different subtype or as an entirely different disorder is less of concern to me than that you understand these are not the same kids. They do not have the same risk, the same co-morbidities, the same causes and the same outcome, and it is likely that they do not respond to the same treatments the same way.

But we will not know any more about treatment if we don’t view them differently, because everyone will assume as you may do, quite naively, that the treatments for one apply to all the subtypes, and they don’t. We have discovered a new disorder and it does not belong here. It needs its own name and its own criteria and it needs to get out of this category known as the disruptive behavior disorders, because it has no affinity for them. So let me show you why many of my colleagues are now slowly coming around to an idea that 10 years ago I argued for. This is a different disorder. Why do I think it’s a different disorder? Because these children come in with the opposite symptoms. Instead of being hyperactive, intrusive, distractable, they’re lethargic, slow-moving, hypoactive, spacey, daydreamy, quiet, passive, withdrawn, confused, in a fog. They are the polar opposite of the AD/HD child in their clinical presentation. This is not an impulsive, disruptive, intrusive, aggressive, emotional, naive child. This is a kid who is staring, daydreaming, confused, and not processing information accurately. This is a real attention deficit, if attention means information processing. These kids have a processing deficit. AD/HD children do not. Do not confuse these two groups. They do not have the same problems with paying attention.

Other things we see in these children: when we bring them into the clinic, and we run them through a battery of neuropsychological tests, they have deficits in an area we call selective attention. Selective attention is how quickly you can deduce what’s important from unimportant in a spatial array of information, how fast you accurately process information coming at you. AD/HD children have no trouble with selective attention. And by the way, let’s put an end then, to this metaphor for AD/HD that it’s a filtering problem. Because it isn’t. Real AD/HD has no trouble with filtering, selecting information. AD/HD children perceive the world exactly as everybody else does. These children don’t. These kids have a selective attention problem, which by the way explains something that we have found in about six different studies. These kids make more mistakes in academic work than AD/HD children do, many more mistakes. The problem that AD/HD children have is with productivity; number of problems attempted. The problem with these kids is accuracy: the number of errors made. These kids have a real problem with input coming into the brain, how quickly they can handle it, how accurately they can select it out, and deal with it. These children have memory problems. AD/HD children do not. These children have trouble with getting information out of short-term and longterm memory and doing it correctly. It’s especially so for long-term memory, so that they show a very erratic recall of information. AD/HD children, if they have a memory problem, it’s going to be in a very unusual form of memory we’re going to talk about later today. But this is traditional long-term storage, and these children have some trouble with that, probably for the same reason. They’re not getting information out of memory any more accurately than they’re processing information coming into the brain.

There are problems with selection, with filtering, with focusing their attention. These children have a very different social profile. The traditional AD/HD child is often a rejected child, because they’re immature and emotional and hotheaded and demanding and controlling and impulsive and often aggressive, so that when we compute a social profile of the AD/HD children they often wind up as being the least liked, the least popular and most likely to fight. That is their peer group profile. That is what Ken Dodge and his profile of peer acceptance views as the rejected child. And 50 percent or more of AD/HD children are utterly rejected by their peer group; these [inattentive] children, very different picture. These children are overlooked. In Ken Dodge’s taxonomy of social problems, they’re neglected. Why? Because they’re passive, uninvolved. They’re staring, daydreaming, hypoactive, absent-minded, passive. Unengaged is a better term for them. They’re not disliked by the other kids. They’re not rejected by them. The other kids just don’t know them. They’re not engaging. They’re not out there participating. They’re just kind of passive kids. They have more friends than AD/HD children have, actually. These kids tend to be neglected, not rejected. It’s a very different social profile.

Other differences: there is no affinity of this disorder for Oppositional (Defiant) or Conduct Disorder that we can tell. They basically have the same base rates as the normal population. But many AD/HD children are likely to go on to develop Oppositional Disorder and Conduct Disorder. Forty-five to 55 percent of AD/HD children develop Oppositional Disorder by age 7, and another 25-45 percent move up to Conduct Disorder by ages 8 to 12. AD/HD goes with Oppositional and Conduct Disorder. The inattentive group does not.

You see another reason why they don’t belong in this group? Those three disorders—AD/HD, ODD, and CD—are all part of a larger category we call the disruptive disorders. The inattentive group isn’t and it shouldn’t be there. Other differences that we see: by definition, of course, these kids are not impulsive. They don’t have any difficulties with inhibition. These children do not respond to stimulants anywhere near as well as AD/HD hyperactive, impulsive children do. Only about one in five of these children will show a sufficiently therapeutic response to maintain them on medication after an initial period of titration. Oh, you’ll find that about two-thirds of them show mild improvement, but those improvements are not enough to justify calling them clinical responders, therapeutic responders. Ninety-two percent of AD/HD children respond to stimulants. Twenty percent of these children respond to stimulants. And the dosing is different. AD/HD children tend to be better on moderate to high doses. Inattentive children, if they’re going to respond at all, it’s at very light doses, small doses. So the drug response is different. And that’s all we know.

[At this time] there are no other studies of treatment of this group—none. The only studies are five involving medication and mine was the only one that tested multiple doses with a placebo control. There are only two pages in my parents’ book, Taking Charge of ADHD, on this group, and it tells you what I just told you. This is what we know. These are different kids. This is a different disorder. Stay tuned. We don’t know what to do with them. It’s up to you. You’re just going to have to cobble together some help any way you can and hope that it works, because there is no science beyond what I just told you.

They may have different causes. They certainly have different family histories. Those children tend to come from families where there are more anxiety disorders and learning disabilities. AD/HD children come from families where there’s more AD/HD, Conduct Disorder, antisocial behavior, and substance abuse. The family histories of these two groups are not the same. Now, we have to be careful here, because the Inattentive group, it turns out, is rather a wastebasket group of kids. First of all, in that group are the true Inattentive kids. But also in that group are AD/HD children who came in one symptom short of being in the Combined group, right? They’ve got six inattention and five hyperactive symptoms, and according to the DSM, if they don’t have six, they’re not in the Combined type. Well, yes they are, and you should think of them as being Combined type children, even if they come up one symptom short. Don’t put those kids into the Inattentive group.

The Inattentive group in our clinic is for kids with three symptoms or fewer off of that HyperactiveImpulsive list. Any more than three and you’re better off thinking of them as what we call subthreshold Combined type children. There’s another group, the group that starts out being in the Combined type and by adolescence or adulthood are no longer so hyperactive, but they meet the criteria on the Hyperactive list. Now you would flip them over into the Inattentive type. Don’t do it. You always think of them as Combined type.

So, bottom line is this: If any point in your history there was a whiff of problems with inhibition and impulse control, you’re a traditional AD/HD Combined type kid, and it shouldn’t matter what the DSM is telling you about cut-off scores. Clinically that’s how you would approach that child. That’s a Combined type kid. And you reserve this Inattentive group for kids who have never in their lives had trouble with inhibition. Those are the spacey, daydreamy, confused, in a fog, sluggish, hypoactive, slow-moving group. And as long as you conceptualize them that way, you won’t make any clinical mistakes. But if you follow the DSM as it’s written—perhaps you have OCD and you just have to follow all those criteria, just as they’re written—then you’re going to get yourself into some trouble.

Because remember, the DSM was not chiseled in stone in Israel. It’s a set of guidelines developed to help make clinical decisions, but it’s to be used with clinical judgment and understanding of the criteria. Okay, that’s just to resolve some confusion.

And by the way, I said the Inattentive group was a wastebasket. Why did I say that? Inattention is nonspecific. Inattention is unhelpful in defining what disorder you have, because most mental disorders produce inattention. So if somebody walks into your clinic and says, you know, I’m having a lot of trouble concentrating, can’t pay attention, can’t finish work, you have no idea what they have. You don’t automatically say, oh, that’s AD/HD, I’ve heard about that. This could be a psychotic. This person could be a substance abuser. This person could have a generalized anxiety disorder or panic attacks or major depression or bipolar illness. How the hell do you know what they have? For now, just know that the Inattentive type of AD/HD is a real wastebasket category of really inattentive children, along with children who have other disorders that are producing their inattention. There really is an Inattentive group out there, but they have a different disorder, and it’s not AD/HD".

Now does that sound like your son?

Now does that sound like your son?
In a lot of ways, it does. One thing is that he is actually quite popular at school. I would call it charisma -- people are drawn to him. So he is not really neglected or unnoticed.

His mind can also work very quickly when he has some pressure. Like when I time him on his flashcards, he goes through them very quickly. Setting new records...

Whatever the doctors said, I am convinced that at the least it isn't just a reading disorder. There are so many other things. And I definitely see your point that just because he focuses in a novel situation doesn't mean his zoning out is because he hates reading.

But I can kind of see their point that without the reading problems, we wouldn't consider him impaired. He would just be a daydreaming, somewhat sub-par but still average performer.

Impairment can be situational and different over time...so your sons impairment now may be only a significant discrepancy between potential and achievement. In the future it may be become much more noticable as he gets into the higher grades where the sheer amount and the complexity of information being learned can be overwhelming. Students under stress and who do poorly at school, can change suddenly in their mood and behaviour.

Not to say that this will happen to your son or that he even has ADHD. I just think these examiners are not the right people to make the call.

Impairment can be situational and different over time...
I agree with you here, but this is where the doctors implied I was projecting onto my son. I told them how I was also considered to be "learning challenged," until they decided that I was "smart but lazy" starting in the third grade. School was not a pleasant experience for me. I was able to bluff my way through for a while on charm, but when teachers started demanding real work the game was up.

I said I could see things playing out this way for my son, and I wanted to avoid it if at all possible.

Objectively, I can see the projection there myself. After all, my son is in the second grade and most of these things have not yet come to pass. But seeing the similarities now, I am quite worried.

This projecting thing doesn't instill any further confidence in their ability to diagnosis ADHD. Can they spell G-E-N-E-T-I-C-S?

Did they at least have you fill out a behaviour checklist or have you give one to one of his teachers? Did they want to look at report cards? How are they assessing how significant a problem daydreaming is in the classroom? I missed all of elementary school daydreaming.

Did they at least have you fill out a behaviour checklist or have you give one to one of his teachers? Did they want to look at report cards? How are they assessing how significant a problem daydreaming is in the classroom? I missed all of elementary school daydreaming. Yes, I did the behavior checklist. I also showed them all his report cards since starting elementary.

Here is a typical comment:I have enjoyed having Sage in my class this summer. He is friendly with his classmates and brings wonderful ideas to our lessons. Sage needs to continue to improve his writing and reading skills. He works well but needs to improve his listening skills at all times.
I asked his second-grade teacher for a letter describing his problems in class, but all she gave me was his work so far this year and his placement tests.

I also wrote up a list of behaviors his first-grade teacher described to me during our many meetings (she has moved back to the US and I couldn't get a hold of her for a letter):



Doing work in class, he is "always" the last one to finish, and often does not finish
He often "zones out," staring into space
Sometimes turns in worksheets completely blank
After she explains how to do something, he will raise his hand and say "I don't understand."
When spoken to, he often appears to be ignoring you or to not hear you
She recommended he be held back because he could not keep up with the other children in class.

It would be interesting to know where his IQ scores are at and how his hearing is.

So being so below class performance, in grade one, that the teacher recommends retention, doesn't show impairment? What would the poor kid have to do to get noticed?

Strange, it doesn't sound like they actually requested any information about his behaviour at school and I am also assuming that they didn't request that a teacher fill out a checklist.

It would be interesting to know where his IQ scores are at and how his hearing is.
His hearing is fine -- we had that checked pretty early on. Have never done an IQ test, but he appears "bright." Even the doctors said he seems very intelligent -- definitely not retarded, they said.

So being so below class performance, in grade one, that the teacher recommends retention, doesn't show impairment? What would the poor kid have to do to get noticed?

Be hyper? That's only half facetious.

But the school's main reason for recommending he be held back was his low reading scores. He does read below the level of his peers, but after having volunteered in class and having had most of his classmates read to me one on one, I would honestly say it is a matter of degree and not a major difference.

Strange, it doesn't sound like they actually requested any information about his behaviour at school and I am also assuming that they didn't request that a teacher fill out a checklist.
No, they didn't ask for anything except the checksheet from me -- but I gave it to them anyway. :)

Here's one of the actual questions asked of Russ Barkley at the March teleconference on ADHD in kids.

A psychologist phoned in and asked something to the effect of " How is that whenever I get a child who is coming in for an ADHD evaluation, they're perfectly behaved in the office?"

His response was to qoute a research article that said that exact things happens a significant amount of time. In fact, he said it was to be expected.

I can't asnwer specific questions but keep in mind that Inattentive type often shows up later than Hyperactivity.

If you're (meaning the reason for the referral) looking at strictly ADD-I, then a clinician needs to assess "Working Memory" with the Behavior Rating Inventory of Executive Function (BRIEF) and NOT the subtest scatter from the WISC-IV.

There are other tests to give besides the BRIEF and there's nothing wrong with getting a baseline of cognitive function (intelligence). JUst don't use the IQ test to make the diagnosis.

Russ's ADHD : A Handbook for Diagnosis and Treatment (Third Edition ) should have just come out at the end of August on Guilford Press. It has the "checklists trumpt test's" data in there to support that.

I haven't seen it yet but thats what he said in March.

There is a Working Memory Index (WMI) on the WISC-IV, however, it doesn't compare to the BRIEF.

The other 2 outstanding checklists for kids are : George DuPaul's ADHD-IV checklist and the Conners Parent Rating Scale.

The current state of the art, meaning research supported, is that teachers checklists only match parents (on average) 3% of the time!!!!!

Im qouting Dr Barkley here.


The BRIEF is the best diagnostic tool available and its teacher /parent correlation is (I think) somewhere between .32-.34.

That sucks:)

Thanks a lot for the reply, mctavish.

To be honest, a lot of it looks like alphabet soup to me. :) And I suppose this information will take a couple of years to filter into the backwaters of Japanese medicine.

One thing I should mention is that a lot of the behaviors mentioned by my son's first-grade teacher are much better after some simple interventions I requested, like sitting him in the front of the class, ensuring frequently that he was paying attention, and making sure his day's homework was written in his notebook. But those were the initial symptoms that got me off my butt to research ADD.

Hi Uminchi :)

You have gotten alot of great information here, there isn't much for me to add, just that I would definetly get another Doctors opinion even if it means seeing two or more Doctors. I had to do this with Cody, I had Doctors telling me it was just anxiety, then I had Doctors tell me he was ADHD , which is true, but it took quiet a while for a Doctor ( our new one) to see that Bipolar was a big issue. Stick to your guns, he is your Son, and you know him best and if in your heart you feel there is more to this than what these doctors are saying go with it. I hope that his teacher does her job as well, I know you've had some problems with her, keep at em Girl! Keep us posted, Your in my thoughts! :D

You have gotten alot of great information here, there isn't much for me to add, just that I would definetly get another Doctors opinion even if it means seeing two or more Doctors.
Thanks for the support, CJs. My son isn't done with his testing, though. There are still about three days of testing left, to be spread over several weeks, before they will make their decision. It's just that after the first day, the doctor said she was inclined to focus more on a reading disorder than ADD. I'm like hmm... but we'll see.

It's interesting, you're not the first person in this forum who has thought I was a woman (I'm a man). I take it as a complement because I assume it means I come accross as sensitive or some other nice quality. But maybe in future I should make more fart jokes or do other manly stuff to avoid confusion. :)

Thanks for the response. It sounds like things are going well and I'm happy for you.

You're also correct that "checklists trump tests." :)

As a child progresses with age and grade levels, the complexity of the material presented and the related cognitive demands required to meet those, increases substantially. In order to successfully meet those demands, the child's Executive Functions need to be at an age appropriate developmental level.

As you know, ADHD is a developmental disability,in that the impairments represent delays relative to the ADHD child's peers.


Good luck.

mctavish23 (Robert )

Uminchu,

When McT said BRIEF my first thought was underwear.

Basically what McT said, if I may paraphrase;
1) behaviour in the testing enviornment counts for squat.
2) that your child may have greater difficulties as he gets older.
3) If he is going to be tested, the IQ test is good info but they shouldn't look for a diagnosis for ADHD from it. He likes his BRIEF(S:D)
4) ..and really checklists are the better way to support an opinion for diagnosis, anyways.

Does that help? :)

Ah, much better scuro. I thank you, and my brain thanks you. :)

Hope I got it right. :p

Uminchu,

The modifications that you requested at his school are a good start.

One thing I would start doing now is letting your son know that he is his own best advocate. If he doesn't understand something, tell him to raise his hand and ask that the teacher repeat it or explain it another way. Everybody learns differently. Just because some kids get it the way the teacher explains it, doesn't mean that everybody does. Chances are that other kids don't understand it either. Also, if he needs more time to complete a test or a worksheet, he should ask for more time. Now is the perfect time for him to start advocating for himself.

Also, I would suggest that you keep a daily journal of his behaviors. From the time he wakes up to the time he goes to bed. Make notes such as "Had to tell him 5 times to get his feet off the table.", "Had a great afternoon. Very cooperative." "Argumentative from the time he woke up. By lunchtime, he was a little better", "Refused to do his homework. Said he was too tired", etc... This way, you can hand over the journal to whomever may benefit. Highlight the areas of concern. (You can also read it when he is in college and wonder how you ever survived it all.)

My adhd/ocd/mood disorder son is now 12. (It's been a l-o-n-g tough 9 years.)

He was so off the chart hyper that he got kicked out of every daycare and preschool around. We were told by the last preschool to "Bring him back when he's properly medicated." We were told by the private Catholic Kindergarten that he went to that "His diploma is in his bookbag and we are going to call it a day." (He graduated several days before everyone else because he wouldn't participate in the graduation ceremonies and was causing turmoil for everyone else that was getting ready for it.)

We went the holistic/homeopathic route first. When we went to the doctor's office, my son was a little angel. I could actually see his halo shining. The homeopathic doctor got out his big books and just stared at my son, my husband and I. He asked a ton of questions and would consult his books. Then my son came out of his shell and acted like he normally did. We got a confirmed adhd diagnosis and started homeopathic meds. The meds worked like a miracle and I kept a daily journal of his behaviors.

When the meds wore off, we'd have to run over for another "remedy". After a while, we couldn't wait for the next remedy to kick in so we went the conventional route too. We did holistic and regular.

When we went to the regular psychiatrist, my son was again a calm, well behaved child. (Kind of like that kid on "Problem Child" that wore the bowtie, etc..but was horrible when not on display.) Then my son opened up and was his normal "hyper" self. We started Ritalin then.

I kept a daily binder type journal for a long time when we were taking the homeopathic meds and the ritalin. Eventually we stopped the homeopathic meds because he was no longer on my insurance.

I signed up for the Early Childhood Program in our area that had a very long waiting list. Once they laid eyes on my son, he was in immediately.

He didn't get a diagnosis of ocd/mood disorder or learning disabled in math and reading until later on in elementary school. Adhd was his diagnosis for quite a while.

He showed signs of reading comprehension and we were sent to be tested by Special School District for audio processing. He didn't do too well in this test. His hearing is fine but what goes in his ears does not always get cycled through to his brain. It gets lost in translation and he only hears parts of it.

They gave us several suggestions for the teachers to use at school and for us to use at home. Such as breaking down the instructions: Get out your science book. Now turn to page 12. Do number 1 through 12 even. And then verify that he understands it.

At home, instead of saying "Pick up all your things in the living room and take it to your bedroom and then hang up all your clothes." We'd say: Pick up your shoes on the floor. Take them in your room. Get out some hangers. Hang up all the clothes that are laying on your bed."

My 14 year old daughter shows signs of adhd but is not yet medicated. She just started highschool and has always been on the honor roll. She does have challenges with reading comprehension, as do I. When I was going to college, if I wasn't interested in what I was reading, I wouldn't retain any of it. I would have to read it out loud a million times and then sometimes write it down. But if I am interested in it, I can read it and retain every last word.

Reading comprehension difficulties and/or audio processing difficulties effect all classes in school. From reading to science to social studies to math. Especially math problems. It's like you can read an entire math problem and say "What in the world are they talking about."

Life is so hard. :)

P.S. No need to do fart jokes. Don't forget...we are from add/adhd families and we hear enough fart jokes as it is. :)

Thanks for the response. It sounds like things are going well and I'm happy for you.
Thanks! BUT -- even after all the hard work and progress my son made, after assessing him in August they still wanted to hold him back -- because of the reading. (By the way: they tried to hold back 4 of the 16 kids in his class, and 3 of the kids in his class had been held back from the year before. So they are retention-happy)

This is the kind of thing I'm up against with this school. In a way I want to make him the best reader in his grade just to spite those wretches; make them eat crow. On the other hand I don't want my kid to develop some sort of complex about reading. He already tells me he doesn't like to read.

The thing is, I know my son has great things buried up in that head of his. And I'm willing to wait to let them come out when they're ready. His school, however, isn't willing to wait.

Retention doesn't work. A kid who fails doesn't bounce right back and happily chirp their way to college. It's not like they learn some life lesson here, unless it is a very negative one. Once you have a problem, you need to address the problem and that is through accommodations or 1 on 1 remediatiaon.

A kid who fails will still be the same number of grade levels behind or worse, in a year or two. Unless someone addresses the problem.

One thing I would start doing now is letting your son know that he is his own best advocate. If he doesn't understand something, tell him to raise his hand and ask that the teacher repeat it or explain it another way.
That's good advice, thanks.

Also, if he needs more time to complete a test or a worksheet, he should ask for more time. Now is the perfect time for him to start advocating for himself.

He will usually get the worksheet to take home as homework. He also sees a tutor at school once a week who helps him catch up with his work.

Sometimes as "punishment" for not getting something done, though, they'll make him do it at recess. This is something I want stopped, and one of the reasons I wanted the dx for him -- so I could have more ammo to get them to change their disciplinary system. Like instead of sitting out recess for being bad, make him sweep the hallway during quiet time. Things like that.

Also, I would suggest that you keep a daily journal of his behaviors.
This is such a great idea. But honestly, I don't have much faith in myself in keeping it up. How do you manage it?

"His diploma is in his bookbag and we are going to call it a day."
That is hilarious. You must never have a dull moment.

They gave us several suggestions for the teachers to use at school and for us to use at home. Such as breaking down the instructions: Get out your science book. Now turn to page 12. Do number 1 through 12 even. And then verify that he understands it.

Yep yep, pretty much how our son is. Even "go upstairs, get a pencil, and come back" can be too much.

Reading comprehension difficulties and/or audio processing difficulties effect all classes in school. From reading to science to social studies to math. Especially math problems. It's like you can read an entire math problem and say "What in the world are they talking about.

That sounds like my son. The funny thing is that he does well on word problems in math. It's like he can suss out the content, but has problems with decoding the sounds.

One of the things the reading specialist said was that his phonics skills were behind. While kids his age should be decoding groups of sounds, he was still sounding out each letter individually, then putting them together.

Life is so hard. :)

Yeah, poor us! :D

P.S. No need to do fart jokes. Don't forget...we are from add/adhd families and we hear enough fart jokes as it is. :)
I don't know -- you can never have too many fart jokes.

You can have too many farts, though. :)

Retention doesn't work. A kid who fails doesn't bounce right back and happily chirp their way to college.
I am with you 100% there.

One of the problems the school faces is lack of funding for specialists. It is a private missionary school in Japan, so is funded entirely through tuition, donations, and fundraisers. They simply don't have the funds to hire special ed instructors.

I understand their dilemma, which is why we have sought outside help for our son on our own.

My daughter is half time home schooled by grandma. They couldn't offer what I wanted so I got the best of both worlds. 1 on 1 works.

Here is Barkley from San Fran 2000 on the diagnosis of ADHD. He is the worlds leading expert on ADHD.

Appropriate Assessment for AD/HD

All right, if you’re going to do an evaluation, what should a clinician be doing? Some parents come in and they say, well, I went to this particular clinic and he gave my child the TOVA (Test of Variables of Attention) and he said that based on that instrument, which is a computerized continuous performance test for measuring attention span and impulse control, he concluded that my child had AD/HD. Or, I went to this other clinic and they gave him the Gordon CPT or I went to this other clinic and they gave him a huge neuropsychological test battery and said that the child has AD/HD. Is that a good evaluation? The answer to all three questions is no. None of those tests are useful for the diagnosis of AD/HD, not in a clinical sense, because they’re not very accurate. Diagnosis is driven by the issues, not by the instruments. Assessment of an AD/HD child is not driven by the methods, it’s driven by the questions.

Once you ask the questions, the methods for answering the questions will fall in place. Here are the issues. What’s the history of these problems? How long have they been around? Are they chronic or periodic? AD/HD is a chronic, unremitting disorder. Bipolar is an episodic disorder. So we need to know the history. We need to know your current concerns. We need to know if they map onto the symptom list in the DSM or not, which means we have to review the DSM. We also need to establish that your level of symptoms is inappropriate for your age group. We’re going to have to do that not only by seeing if you have it at least six out of nine of those symptoms, but we’re going to have to use that well-standardized rating scale to measure how deviant your symptoms are and to compare you to other people of the same age and the same sex to make the diagnosis.

Okay, so right now what do we have? Interviews and rating scales and reviewing the DSM criteria. You must establish impairment. No impairment, no disorder. I don’t care how many symptoms of AD/HD you have, you do not have this disorder if it is not producing impairment in a major life activity, and let’s be very clear. Taking the SATs is not a major life activity. Just because you have failed the SATs three times and otherwise were valedictorian of your class, you do not have AD/HD.

All right, we also need to find out what other disorders you have. Why? Because co-morbidity is common among mental disorders. Very few people have a single disorder. Only 25 percent of all children referred for AD/HD only have AD/HD. The other three-quarters of them will have at least one or two other disorders. That means you not only have to go over the symptoms of AD/HD from the DSM, you have to go over the symptoms and diagnostic criteria for other disorders, too, like major depression, anxiety disorder, the learning disabilities, ODD, Conduct Disorder. So notice the evaluation is a differential diagnosis, not just a review of AD/HD and then we’re done. Finally, you have to rule out other possible explanations. Is this a retarded child? Is that why they’re failing at school and not paying attention? Is it low IQ? You need to do a quick screen for IQ, whether it’s using the Wechsler shortscale or using the Kaufman Brief Intelligence Test.

Second, 50 percent of AD/HD children have a learning disability. You better screen for reading, math, and spelling and see whether this child has a learning disorder. That doesn’t mean that the learning disability explains their problem, because it may not. These are two separate disorders that co-exist very frequently. But you need to screen for it because many AD/HD children have a learning disability along with their AD/HD.

Finally, if you’re seeing teenagers and adults, is it possible that they’re smoking dope before they go into school? So you may want to do a review of substance use, and if you don’t trust them, even a urine panel to see whether or not they’re really using drugs. Bear in mind, 18-20 percent of AD/HD teens are substance abusers. So, don’t you want to know that? Is that where the inattention comes from? Or is that exacerbating the symptoms that they already have? Is there more impairment here because of that?

So notice, the evaluation of an AD/HD child then would include the following five methods because these are the things you have to do to answer those questions. One, a clinical interview with the individual and people who know them well. Two, you must review the DSM criteria for this and other major disorders. Three, you’re going to have to use a rating scale to measure how deviant the symptoms are. Four, you need to screen out low IQ and developmental delay. Five, you need to screen for learning disabilities to see if they’re co-morbid because they will be in 50 percent of all cases. And if you want to add a sixth, it would be get the records from the school and all past evaluations on this individual. And then you can make a diagnosis. No testing. There’s nothing on an intelligence test that will diagnose AD/HD. There is nothing on a computer test. There is nothing in a neuropsych battery that can reliably diagnose this disorder. You’re just wasting time and money.

Thanks for posting this, scuro.

Today my son goes in for more testing. I think it will be an IQ test and screening for sensory disorders -- it's hard to tell because Japanese doctors don't tend to tell patients what they are doing, and I was zoning out after 3 hours in there anyway -- so it looks like they are screening for the things you mentioned.

Thanks Scuro! Very informative post!

Scattered

Scuro,

Thanks for the Barkley qoute.Could you please post the link or the reference?

I can already see myself (figuratively) rolling it up and smacking my colleagues in the head with it when we present in Oct.


I also agree about NO rentention!!


thanks

This link goes to the page where you can get the PDF file.

http://www.schwablearning.org/Articles.asp?r=54

Thanks :)

Just an update on the diagnosis front.

They gave my son an IQ test last week. A week from Monday will be a test for sensory disorders (yes, they work slowly in Japan).

They don't have the results from the IQ test yet, but said he did "fine" except he seems to have some auditory processing problems (in one ear and out the other -- yep!).

Meanwhile, on the school front, son's teacher says he is "working hard." He has actually made a huge amount of progress and I'm very proud of him. All the praise heaped on him by his two outside tutors seems to really be helping.

But at school, kids get tickets for doing their schoolwork, and then get them taken away for being "bad." Get enough tickets and you pick a toy out of the prize box. Most of the other kids have around 20 tickets -- son has 8.
Me: Why do your tickets get taken away?
Son: For playing with my pencil, not doing my work, not listening.
Me: That's it? You lost all those tickets for not paying attention?
Son: But dad, I'm just thinking!
Me: I know, buddy.
It really breaks my heart that my son is getting punitive treatment for something he really can't help. On the other hand it ticks me off that his teacher could be so heartless, when she knew about these problems from day 1. She really seems to be intent on living up to her "no special treatment" mantra. :mad:

Hopefully with a diagnosis in hand I can be more convincing!

But if things don't turn around, I'll be seriously looking into home schooling.

I wanted to clarify one thing I overlooked.

Behavioral observation is the only way to detect hyperative behavior.

It does get confusing tho. What I was trying to say earlier was to not put too much emphasis on a child who might possible be hyperactive behaving perfectly in an office visit.

What I do is haul out the toys or some games from one of my office closet's and basically "turn them loose" while I talk with the parents.

I came out of a very strict/hard core behavioral gradschool program, so I can observe behavior very well .

What happens is at the end of the session, I'll literally have down how many interruptions, times out of seat, changes from one activity to another, and still explain things and ask questions of the parents.


I do the same thing at the second session as well. Then, if I were to test the child later, that would require at least 1 1/2 hr-2 hrs of sitting with me in the office. That's another opportunity to observe them;only this time it;s during some structured tasks.

If all of that matches and seems consistent over time, then thats valuable data.

Thanks for the insight, mctavish.

I wonder, is there anything in particular you look for with innatentive-type (non-hyperactive) kids?

Our son's first appointment was two 1.5-hour sessions, with a 45-minute break for lunch in between.

In the first session, they mainly asked us lots of questions and looked at the documents we brought. Son started going a bit wild so they gave him some paper and a pen, and let him go to town. They were very impressed that he was able to sit and draw for 30 minutes straight.

Then the afternoon session was with the neuropsychiatrist. They let the boy go to town on a Lego set, with the psychologist and an intern playing together, while the psychiatrist talked to us and observed son. She was the one who said, "He's concentrating fine now..." I'm like yeah, but that doesn't mean we or his teachers are lying either...

But at school, kids get tickets for doing their schoolwork, and then get them taken away for being "bad." Get enough tickets and you pick a toy out of the prize box. Most of the other kids have around 20 tickets -- son has 8.
Me: Why do your tickets get taken away?
Son: For playing with my pencil, not doing my work, not listening.
Me: That's it? You lost all those tickets for not paying attention?
Son: But dad, I'm just thinking!
Me: I know, buddy.
It really breaks my heart that my son is getting punitive treatment for something he really can't help. On the other hand it ticks me off that his teacher could be so heartless, when she knew about these problems from day 1. She really seems to be intent on living up to her "no special treatment" mantra. :mad:


You give to each student according to his need. Some teachers can be so dumb sometimes....and I have a right to say this because I am a teacher!

What really bothers me about Behaviour Mod, is how often it is abused by people in authority and ends up being a negative reinforcer. These people should be lashed with a wet noodle, actually if I had my way it would be a whip and maybe the lesson would be learned that you don't always have to crack a nut with a hammer.

If I remember Barkley correctly, he said even the student with the greatest behaviour difficulties should get two tokens for every token taken away. That everyones token total is public knowledge, is a sophisticated way of publicly telling the other students that your son is deficient or bad.

I posted before about how rewards and punishment never seemed to work for my son. Our Doc told us that this is common w/ ADD kids. She went on to say that because they really don't know what to do to fix the problem, they condition themselves not to care about the reward or punishment. It seems to be unattainable to them, and in order to preserve some sense of self-worth, and prevent being disappointed all the time, they just condition themselves not to care anyway.

Once she pointed this out to me, it really made sense. I have seen this happen with my son time & time again. Anyway, long term it does affect self esteem. They start to think that the other kids are better, smarter, whatever, because the others have tickets, or manage to get their work done, or whatever. Instead, the ADD child finds his comfort zone in the middle, flying under the radar screen, with his competitive spirit and ambition damaged. I am now trying to undo some of what has happened. But it is difficult.

Be CAREFUL in letting them hold him back too much!! Children learn a lot from their peers and if the age gap becomes too much, so will the developmental gap.

I'm not sure what method they are using to teach him reading, but no one way works for all kids. If they are trying whole word you might try supplementing with phonics. I'd also advise dropping his reading down a level and work on fluency and self esteem in reading. If reading in a group or reading slower makes you feel like a dummy, your not very likely to want to do it. The same thing happens with kids. Build confidence and he'll be more likely to take the next steps with more ease and determination.

I'm sure they'll test for scotopic sensitivities and dyslexia, too. but trying a color overlay may be a quick help for now. Testing sometimes takes a bit too long.

Getting "tickets" or "zip slips," which is what they're called around here, are examples of "impairments in major life activities" for a kid.:)

Jaycee:

Thanks for the advice. We have fought very hard to keep them from holding back our son, and will continue to do so.

We use a combination of phonics and "sight words" to teach reading. He has his troubles with both approaches. With his phonics problems it's hard to tell whether he is just behind or has some processing problems. With the "sight words" he can memorize the words in isolation but in context has problems.

We/they ruled out dyslexia fairly early on. He still reverses his b's and d's, but doesn't really exhibit the symptoms of dyslexia. But the testing continues...

Getting "tickets" or "zip slips," which is what they're called around here, are examples of "impairments in major life activities" for a kid.:)
I would have to agree that it is an impairment, although I can't help thinking that the problem is the teacher's, not my son's. Typical parent, I suppose. :)

If I remember Barkley correctly, he said even the student with the greatest behaviour difficulties should get two tokens for every token taken away. That everyones token total is public knowledge, is a sophisticated way of publicly telling the other students that your son is deficient or bad.
Yes. I was talking to a teacher yesterday, who said schools are moving back toward humiliation as a form of discipline. I think she put is as "peer pressure." Which is great, but you don't take tickets away from a kid with a hearing impairment for asking the teacher to repeat herself. But you do take it away from a kid with an attention impairment for asking the same thing?

Take that idea and drive it home. You may teach them something.


...and then there is the idea of why would you try to teach a child to read at grade level, when emotionaly he could be several years behind? It could be a developmental thing...and he just is not ready.

I must admitt that at the high school level I see a lot of kids with "dystaughtia". No one took the time to find out thier learning styles and they just keep faliing behind until there's no catching up.
I think some teachers are so caught up in their own teaching methods that they don't look beyond for solutions. And I have to agree that he may not be ready. I'm not sure why teachers refuse to drop down and try for fluency at a lower level.

My other thought is that if your son is absorbing another language that it may cause a delay. Bilingual students raised in bileingual households are noteable for having "delayed speech" when they are young. After their brains organize the difference between the languages they take off.

Since you live overseas, this may add into the problem if he's just a slow starter in reading readiness. If you still think there are attention issues after the doctors have diagnosed, there are some supplemental type substances (ie Omega 3, Magnesium,ect) that many swear by. Just make sure it's okay to take with any of the mmedications he may be taking.

My other thought is that if your son is absorbing another language that it may cause a delay. Bilingual students raised in bileingual households are noteable for having "delayed speech" when they are young. After their brains organize the difference between the languages they take off.
That is naturally a concern, and I am sure that being bilingual is slowing down his reading and writing to some degree.

However, that is not enough to explain his reading delays. Especially since 70% or so of his peers have one or two Japanese parents, and he was behind all of them.

If you still think there are attention issues after the doctors have diagnosed, there are some supplemental type substances (ie Omega 3, Magnesium,ect) that many swear by. Just make sure it's okay to take with any of the mmedications he may be taking.
The Japanese diet is already fairly rich in Omega 3 fatty acids, due to the high consumption of fish. We try to keep the tuna to a minimum, but eat a lot of the smaller fish like mackerel and salmon.

I haven't looked into other supplements, like magnesium. Could you point me to some research into what they are supposed to improve?

...and then there is the idea of why would you try to teach a child to read at grade level, when emotionaly he could be several years behind? It could be a developmental thing...and he just is not ready.
I agree. I knew that his reading was behind, but was not too worried. But the school trying to hold him back naturally put a lot of pressure on me to get his reading level up.

And he has improved quite a bit. I would even say that he is around the middle of the pack reading-wise. And he managed to get there without starting to hate reading.

I haven't looked into other supplements, like magnesium. Could you point me to some research into what they are supposed to improve?

Some board members swear by supplements and I suppose that there is no harm in trying them. There is no body of evidence that any one supplement clinically helps ADHD.

More here ->http://www.addforums.com/forums/showthread.php?t=17659&highlight=Magnesium

There are several theories on supplements that mineral deffeciencies are part of the chemical problem associated with ADHD. When you replace the minerals you make the brain work more effeciently by giving it the extra chemicals it was low on. The medical community is very frank about the lack of studies on the use of supplements. However there are a few doctors who have shown that they are working in a clinical setting. Dr. Emily L Stevens, Dr Daniel Amens are two. Here are some of the supplements that they have found helpful.
Omega-3
Magnesium
L-Triptophan
GABA
B-complexs
Grape Seed Oil
There are also a lot of people using Acetyl L-Carnitine which is said to help when aggressive behavior is involved.
Ginko Biloba has been used, but it only helps increase blood flow to the brain. It does not generally improve synapse response.
Here's one link that does have some research.
http://www.raysahelian.com/adhd.html

Going all the way back to the 1970"s and the Feingold Diet and up and thru the Zone Diet, there have been no research substantiated nutritional supplements or dietary changes that have ever been found to work as a clinical treatment for ADHD.

There were thought to be possibly 5% of ADHD children who might have sensitivities to certain foods (food allergies). However, adressing those only helps the food allergies.

As someone who had his first sinus operation at age 5, I fully realize that successfully treating any allergy will have a definate positive impact on the wellbeing of the child.

It just won't treat the ADHD.

Omega 3 long chain fatty acids, which I do take as a supplement, have shown some promise.There has also been mention of a high protein diet, however, neither one of these has been consistently shown to be a clinical treatment.

If something does come out of this area, my money would be on Omega 3's.

If you're going to take them, don't expect anything more than they're a supplement to proven clinical treatments.

Having said that, always look for "pharmaceutical grade."

I've posted this before, but one of the people who I personally like and respect is Dr.John F.Taylor.

He was actually a student of Benjamin Feingold. You might want to look at some of his ideas, with the caveat that NONE of these have been shown to work for ADHD.

The last study I read on this, which is at the office, was an English study.

What I recall it saying is that the none of the nutritional/dietary changes made with the children with ADHD, had any impact on the reduction of ADHD symptoms or in improving their performance.

As I said , the article summary is at the office, so I'm paraphrasing here.

What the authors did find tho is very interesting. Even tho there were no gains made in any areas, the parents "thought" there were.

Basically, it came down to "wishful thinking" instead of real changes.

I'll be glad to find that and post the summary when I get a chance.

This is always an interesting topic.


My references are : ADHD and the Nature of Self-Control (1997), by Russ Barkley and the 2004 US Surgeon General's Report on Mental Health ( Chapter 3) Disorders of Infancy, Childhood and Adolescence.

Any mainstream ADHD book will have the same info, as this topic comes up all the time.

It would be great if something were found, it's just not happening right now.

Here's one link that does have some research.
http://www.raysahelian.com/adhd.html
OK, thanks for the link. I would feel more confident about the information if they were not selling the supplements they mention, but it does seem like a good clearinghouse of the various reported benefits.

I know some of the research out there doesn't support nutritional changes as effective in clinical studies with ADHD, but my understanding was that for some children it was effective. Just speaking personally here, not knocking the research or medication -- but in 8th grade when for religious reasons I quit eating sugar and refined foods, I spent the next four years on the honor roll -- that was quite a change for me! Maybe other factors were involved (but not medication since my parents had nixed that) but I definately noticed the difference and from my understanding that is a time when girl's ADHD often gets worse not better.

My only point here is that there's really no down side in eating more healthfully -- probably everyone would do better -- ADD or not.:)

Scattered

My only point here is that there's really no down side in eating more healthfully -- probably everyone would do better -- ADD or not.:)

You'll get no arguments from me there! We are lucky in that we live in a rural area of Okinawa and have access to fresh fish, healthy veggies, free-range chicken eggs, etc.

But I see eating healthy and taking supplements as different things. I'm not real big on supplements except in specific circumstances, like a restricted-calorie diet, pregnancy, certain digestive disorders, and the like. That said, I take a multivitamin because my eating habits aren't quite as good as my son's. :)

We got the full diagnosis finished today.

Result: attention deficit disorder without hyperactivity

No sensory or processing disorders
No reading disorders or other learning disabilities

Poor handwriting, reading, and writing skills are due to lack of maturity and impatience. Retention in grade would be a "disaster" for his development.

They recommend changing the classroom environment in a number of ADHD-friendly ways, and tracking him for a few months to see if he needs medication.

Overall, I am very happy with this diagnosis. I felt that the doctors really cared for my son. One thing I can say is they didn't rush into anything!

So, one diagnosis down, one to go! :)

I'm happy for you! It's good to know what you're working with and have somebody on your side to help implement it!:)

Looking back that sounded weird -- I'm not happy he has ADHD. But I definately feel it is best to know what you're dealing with so you can adapt your approach accordingly. I know it has really helped in understand my daughter (of course her being practically a carbon copy of me helped a bit too!;)

One to go!

Scattered

I know exactly what you mean, Scattered -- it is just good to know.

At first I was a little nervous about the diagnostic process, because the doctors told me they were "leaning" toward one or another diagnosis. First it was a reading disorder, then an auditory processing problem, etc. But I was very impressed by how they were ready to discard one hypothesis as more evidence became available.

Basically, they went down and ruled out all the other potential problems, and when nothing else was left, it was ADD-inattentive. I don't have a lot of experience with psychologists/psychiatrists, but I hope that all of them can be as honest/caring as this team.

I'm also happy for you.

I was very impressed with what you described.

A nice development. :)

It is great news that you now know where you stand! I keep thinking how much better it might have been to know earlier.

About the reading situation - do you read out loud to him regularly, where he can follow along with the book, and look at pictures? I found this helped in a couple of ways. First, they learn to focus on the book, and your voice and the process of listening. It cultivates the ability to stay tuned in to another person speaking. At his age, they still like hanging out with you, so this really can work, and it doesn't seem like a lesson. ;) Of course you need to be an "interesting" reader... don't skimp on your delivery! Even if they don't always follow along with the words, they will sometimes. Point out from time to time where you are on the page. Then evolve into where you take turns reading sentences aloud, or paragraphs, or whatever. Even after they learn to read better alone, the reading out loud thing can keep them motivated as they realize how much more interesting the stories can be as you move "up" in skill. Sometimes it even keeps you from having to go to bed on time!

Oh, and one more thing...

I couldn't agree more about holding him back being disasterous for his development. To me, the absolute worst thing for an inattentive is to be in a class that is boring. I was horrified to have a teacher suggest in our 504 meeting that my son should be taken out of the honors class if he struggled with managing his work. What she doesn't realize is that the less interesting the classroom discussion is, the less likely he is to pay attention to it, and be interested in the assignments. The honors classes have more stimulating dialogue. Fortunately all the other teachers in the meeting glared at her, and I was proud to hear my son say he wanted to stay in the class, because he liked it, and would work hard to keep up. Of course, he is still forgetful, but he is trying.

About the reading situation - do you read out loud to him regularly, where he can follow along with the book, and look at pictures?
Yes, I read to him pretty regularly. His big favorite is "Captain Underpants." I tend to point to the line I am on when in long passages, and he always wants to learn how to pronounce the sound effects, etc.

As part of his "study checksheet," he also reads to me or his mom every day. Doing this, his reading has really improved a lot. His writing is still lagging quite a bit, but first things first, I say... :)

We were big fans of the Magic Tree House series, by Mary Pope Osborne.

I was horrified to have a teacher suggest in our 504 meeting that my son should be taken out of the honors class if he struggled with managing his work.
I can certainly relate here. When I went to highschool, I told my counselors I wanted out of the gifted program. They tried to talk me out of it, but I was like, I'm getting Cs and Ds, this is ridiculous. As a compromise, I dropped all my gifted classes except one.

Within a year, I was on the verge of flunking out. :)

Rudolph Dreikurs (the guy that brought Alfred Adler's work to America) is a big hero of mine in the field of psychology and education. He always insisted that you teach to a student's strength's not weaknesses. We tend to look for what a kid is worst at, focus all our time on that, remove them from everything where they excel, so they'll have more time to spend with their weakness -- lovely!:mad: So you end up with a discouraged kid who no longer believes in himself. Go for the challenge and the stimulating educational areas and then show them how those weak areas are useful in furthering their passion. This also helps them believe in themselves -- combine those two things (believing in yourself and interesting challenges and you've got a recipee for success).

I was in summer school for math in 5th grade. About that time I started taking music lessons. I spent more and more time on music, eventually learning French Horn, guitar, and piano. Did that time away from studies hurt me -- no way -- my grade gradually started improving as I had something I could do that built my confidence and made me feel special.


My daughter was just tested to find her baseline today -- she is ADHD and dyslexic. She's in 2nd grade and has an IQ in the superior range, but is reading at first grade level and her math scores didn't even make the chart. However, ask her about a wide variety of animals and you'll think you just entered the natural history museum as she feeds you stats about habitat, physical characteristic, eating habits, etc, etc, etc. When she goes to the book store she picks out books on geography, world cultures, nature -- and laborously forces herself to sound out words so she can glean the meaning -- I know she'll get her reading down, because she needs it so much to pursue her passion. Without that challenge, she wouldn't bother much. Always resist anyone who tries to remove the challenge from your child's life -- all children need it and ADHD will not succeed without it. IMHO!:p

Scattered

I feel for you.

I recommend you do some research on learning related vision problems. My daughter was screened as a 5th grader and the results showed her "at risk" in several categories. She's been working with an O.D. on vision therapy, and has seen significant results. She is reading quicker, understanding more, and retaining a lot. Her grades are improving dramatically. She also takes Concerta (yeah, concerta!)

Following is a summary of information from Dr. John Tassinari, her O.D. Essentailly, there are four areas of vision: ocular motor skills, visual perceptual morot skills, basic sight and eye health.

Visual Perciptual Motor Skills
visual motor integration
visualization
visual memory
visual analysis
visual spacial
visual auditory integration

ocular motor skills
eye teaming
eye focusing
eye tracking

basic sight
visual acuity
optical deviations requiring glasses
depth perception
color vision

eye health
eye disease
developmental defects

Check out www.drjtvt.com (http://www.drjtvt.com) for the details. It's got a lot of great information.Your child may experience significant improvements in school by identifying and correcting visual problems. Not to imply he is not ADHD. I'm convinced everyone is. Maybe I'm projecting, too.

Good luck!
~Debra

That was very well said Debra.

I've had several ADHD kids undergo vision therapy for reading problems (not for ADHD). It was definately helpful to them.

The same holds true for Occupational therapy for fine -motor coordination problems;including handwriting.

I usually suggest looking at an OT referral from a fine motor standpoint and not a sensory one, as some insurance companies won't cover that.

The truth is that if a child has ADHD, there's an excellent chance that there may be fine motor problems.

There's so much we don't know about ADHD, as well as what other comorbid problems do to impair the child.

I have read an article on Conversion Insufficiency that I believe a Forum member posted some time ago.

While definately interesting, much more research is needed before an evidenced based connection can be made.

Thanks for the insightful post.:)

mctavish23 (Robert)

The truth is that if a child has ADHD, there's an excellent chance that there may be fine motor problems.
What's funny in my son's case is that his handwriting is horrible, but his fine motor skills are good. He can draw nice pictures, and he can draw a straight line right across the page, build a house of cards, etc.

I think it's more an impatience thing in his case, wanting to get it done as fast as possible. Once in a while, he will write very neatly.