6 year old girl with ADHD and a lopsided WISC-IV - now what?
December 15, 2017 8:32 AM   Subscribe

She just got assessed and the psychologist strongly urged me to seek treatment (behavioural and possibly meds) for ADHD for my 6 year old daughter. Her WISC-IV score ranged from 98th percentile to 48th, and averaged out at 122, but the psychologist said it was all over the place and may change with treatment or improvement to her concentration and procession speed. She also has mild dyslexia.

I wasn't expecting ADHD as she can concentrate at length on things she's interested in. However in hindsight, I had adapted to her needs with a heavily nature and physical homeschool curriculum that was interest-led, and she has strong social skills with a happy friendly personality so she hasn't suffered socially yet.

She is about to start formal school in grade one. The school does very little special needs support and has already identified her as a likely challenging student. I'm also apprehensive that her frustration with school will be dismissed as ADHD behaviour alone, not anything else. I've signed up to volunteer at the school, have a language tutor and will be getting dyslexia/reading support. She's already involved in two sports, and will be getting more exercise and a regular routine.

For ADHD - what do I do? What books/resources for me as the parent, what books for her as the child to help her understand ADHD, what other resources are recommended? (Last time a similar question was asked here was 2014)
posted by anonymous to Human Relations (8 answers total) 2 users marked this as a favorite
I wasn't expecting ADHD as she can concentrate at length on things she's interested in

Hyperfocusing is a common trait in people with ADHD.

she has strong social skills with a happy friendly personality so she hasn't suffered socially yet

Aw, that's a sad "yet" there. ADHD can make people annoying, but it isn't inevitable. We're also often funny, and interested in a wide range of subjects.

Could you ask the mods to add a location to your question? It will make a difference as far as giving advice on schools and other resources -- if you're in the US you need advice on IEPs, but I'm guessing you're in the UK. It sounds like you're doing a lot already and are on top of things, which is great.
posted by The corpse in the library at 9:07 AM on December 15, 2017 [3 favorites]

It sounds as if she is twice exceptional (2E): gifted, but with challenges. You have to be her advocate in school, to make sure they recognize both the challenges and the gifts.

There are a ton of good resources for parents of 2E kids. It's been a long time since I have looked at all this (my 2E kid is now 25), but back in the day, when she was young, I liked the 2E Newsletter, Hoagie's Page (almost TOO much information there!), and Wrightslaw (if you are in the US), among others.

Also, 2nd'ing The corpse in the library's comment that hyperfocusing is an ADHD trait.
posted by merejane at 10:03 AM on December 15, 2017 [3 favorites]

Our son was similarly diagnosed at age 7 (without the dyslexia). Super intelligent but nearly zero ability to concentrate on school things. We fought getting him tested because we could see him focus intently on some things and we figured he was just bored in public school. Add that to the fact that he was "tethered" to a desk and chair all day in a lecture format and we thought it was the school, not him.

So we pulled him from his otherwise well-regarded public school and put him in an academically rigorous non-traditional school. There are no desks and chairs, the teaching is not a lecture format but an interactive and dynamic learning environment. Unfortunately, despite him actually liking school and being in a format that was as far from boring and rote as possible, the same focus issues remained.

We medicate. Didn't want to, tried alternatives, hated the idea on every level. But the ADHD started taking a toll on his self esteem. Everyone around him could see that he was likely one of the most intelligent kids in the school, but he just couldn't sustain focus long enough to get the work done. No one cared since it was second grade and there are no grades and he loved learning, but he started noticing that he was not able to execute like the other kids and started internalizing negative feelings around that. He would say he is stupid and hated that he couldn't do more. He was also super-frustrated because he wanted to put out better work product but just couldn't.

He is on a very, very low dose (1/3 of the initial dosing the doctor prescribed and he is actually 10 pounds heavier today) and he only takes it school days. He feels really great about himself (socially and academically) and is amazingly happy. For that reason alone, I do not regret medicating him a bit. Our hope is that once he learns what it is like to focus (he had no idea what that meant before), he can develop a skill set to accommodate the ADHD. Also, when I asked our doctor if he would have to be on this medicine his whole life, he said "If he is, he will have picked the wrong profession". In other words, his brain is just fine as is, but schooling requires a different kind of brain functioning, which the medication helps.

We have never told our son that he has ADHD (he is 8 now). I don't like labels and I didn't want him to internalize that there was some "problem" with him. Rather, we explained that we got his brain tested to understand what his strengths are and what areas are more of a challenge for him so that we best serve his individual needs. We explained that everyone's brains and bodies are different and that is ok! We explained the medication as something similar to the glasses I wear. My eyes need glasses to see far away just like his brain needs medicine to help him focus better. No judgment, just everyone's bodies work differently. There will be a day we tell him the actual diagnosis, but I want to wait until he is older and can process it in a more mature fashion.

Trust your experience as your daughter's biggest advocate and you will make the best choices for her!
posted by murrey at 10:12 AM on December 15, 2017 [12 favorites]

It's too bad they used the WISC-IV, since WISC-V has been out for a couple years now and has a wider variety of subtests that can be used to pinpoint strengths and weaknesses. The strategies you already have planned look good and I'm sure other posters will have more, so my advice is if after six months or a year you feel like things aren't working or like you don't have a good handle on what's going on with her, reassess with the newer test.
posted by Flannery Culp at 10:17 AM on December 15, 2017

Has she actually been evaluated for ADHD? I don't think WISC alone can be used to diagnose, particularly if you, the parent, don't have concerns about focus at home. I'm not sure if you're in the US or not, but if you are in the US, I'd ask to have the school evaluate her for ADHD after she's had enough time to adjust to the classroom. If you're not in the US, I'm not sure what your legal rights are, but it still makes sense to do a full ADHD evaluation once she's in a formal school setting.
posted by yarly at 11:23 AM on December 15, 2017 [1 favorite]

The school does very little special needs support and has already identified her as a likely challenging student.

LOL if you are in the US and her school is a public school this bullshit is a job for the friendly folks at your local PTI.
posted by Snarl Furillo at 7:28 PM on December 15, 2017

If you haven't already, you might consider getting an occupational therapist evaluation - we've struggled for a few years with how to help our 6yr old/1st grader, who is very bright and is either very focused or not focused depending on the his interest in the subject matter. We've already switched schools once since he started K last year and I've wondered if ultimately we'll have to pull him out and home school. Every teacher or care provider who has interacted with him since he was about 2 has commented on how smart he is, but I worry that he won't get the academic challenge he needs in school b/c of his behavior issues - he got really low marks on his 'report card' on the things he doesn't like last month. The OT assessment was recommended to us by a psychiatrist as a first step when we called her about an assessment (I was always very reluctant to say ADHD, I just asked for help), and I'm so happy we did it. I feel like it's the first time our child has been looked holistically (vs. the drs visits and the physical therapy evals, and the eye exam, etc.) The OT identified a number of issues which we've been working on, and gave us great strategies for home and school. While she's never used the term 'sensory processing disorder', when you read what she wrote it aligns pretty well with how SPD is defined. It's been very helpful to me to understand "this behavior issue is due to this underlying issue", not that he's just undisciplined/misbehaving/etc. SPD and ADHD can have some similar manifestations as far as the lack of attention/focus goes, so if you are doubting the ADHD eval at all it's something to consider. Good luck, these can be tough waters to navigate, and even school environments that seem focused on the 'whole child' can be remarkably lock and step at an early developmental stage.
posted by littlerockgetaway at 9:16 AM on December 16, 2017 [1 favorite]

My 9-year old son also has ADHD and dyslexia, and murrey's answer above is really spot on with our experience.

Our family is medicine-reluctant and I never ever thought I'd medicate my child - but after doing everything else all the resources listed, including dietary changes, breaks, physical activity before/after, providing more structure, improving sleep etc etc, we realized that we were doing him a disservice expecting him to be able to handle school on his own, with his brain (which is a fabulous brain, but not really set up for success in a traditional school environment). He is quite intelligent, but the dyslexia + ADHD + slow processing speed made school really, really hard on him and he was starting to feel stupid as a result. We have been able to turn that around with great teachers and support, and he has now internalized that speed =/ intelligence. But it sucked for a while there. We use the absolute lowest dosage and it is clear that the medicine really works - on the few occasions we've forgotten it, we've gotten a call or email from the teacher saying he seemed different and unable to concentrate or get work done. At one point, our son asked to stop taking it, which we OK'd - and within 2 days he asked to start taking it again, because otherwise he felt he wouldn't be able to the work the school was asking him to do. Everyone's situation is different and only you will know what the right answer is for your child. But if you do end up considering medication, know that you are in good (reluctant) company.

The big thing you will need to do is become an advocate for your child at school. In the US, a medical diagnosis of dyslexia qualifies a student for an IEP (individualized education plan) and this is really key to your child's experience. This is how you start getting the support you need for your daughter - for example, here are some of the specifics in my son's IEP (which the school is only legally obligated to provide if there is an IEP; don't let them try to talk you into a non-binding plan such as a 504):
- my son gets extended time for all tests and tasks
- written questions are read out loud to him by a teacher or aide (word questions in math, social studies etc.)
- he gets help with organization of his work and writing
- he's allowed to do less homework without penalty
- he gets a certain amount of time per week one-on-one with the reading specialist (as well as a few other specialists)
- he's about to get his own in-school laptop with assistive technology (speech to writing; he's a painfully slow writer)

We had such a struggle getting help for him at his first school that we ended up going to another (public) magnet school in the area, and it's been night and day. At our new school, they actually offer him help instead of us having to fight tooth and nail (we ended up having to hire an advocate at the old school), and now he is thriving.

I'm happy to talk with you about this if you would like more information. I remember how lost I felt in the beginning - so much information to try to absorb and I had no idea where to start or what to even ask for. One of the things that helped me was to realize that this is a life-long journey - really, a new reality. I had to throw out any expectations I had based on how his 2 older sisters learned and performed in school, and instead learn to meet him where he was. We skimmed this book and found the ideas in it to be pretty helpful - it helped keep our focus on his strengths, not his weaknesses.

You will absolutely figure this out, and your daughter will do great. Good luck!
posted by widdershins at 1:50 PM on December 20, 2017

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