ADHD with superior working memory and average processing speed?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My ds got the same dx. He has no issues with processing or working memory. And got a surprise bonus asd dx. Then no one since has been able to ‘see ‘ the asd, us included (I keep trying and figure I just don’t know what asd is)
I think there is a type of adhd that is primarily behavioral. Russell Berkley considers it the ‘main’ type of adhd (a disorder of emotional regulation) but bc the dsm doesn’t actually consider emotional regulation to be diagnostic of adhd, if you have a kid with adhd whose primary challenge is true deficits in emotional regulation, you will often get an asd dx. With those kids it’s hard to see it because they socialize and interact in many ways typically - they just can’t really control their responses properly so it sort of looks like parts of asd in some ways. Adhd dude talks about this also - as does our psychiatrist. Is it accurate to consider it asd? Maybe - it just doesn’t fit with ‘classic’ asd and the marketing of ‘new add’ had been a bit sub par so it leaves parents super confused. More likely there is a ‘third’ thing that is a subtype of one or the other that hasn’t yet been named.

Than you for sharing. Just to clarify, are you saying that Russell Barkley would likely define all of this under ADHD but that the DSM doesn't define the emotional part as ADHD so an ASD diagnosis is added to account for that side of things?

That could definitely explain the diagnosis. I guess I am surprised because, don't we all know that emotional regulation IS part of ADHD and executive functions?

Also, wouldn't ADHD and anxiety account for a lot of the same behaviors?

m



I’m not exactly saying the asd dx is there to explain ‘non dam’ adhd. I think what I’m saying is what Russell Berkley sees (and many of us see) as the defining characteristic of adhd is not even in the dsm. Adhd is poorly understood and poorly characterized (as is asd) so often kids will get both dx to explain the ‘slightly inexplicable’
Put it this way - if there was another separate dx - let’s call it ‘pikachu’ - where the constituent pieces were lack of emotional regulation, impulse control, inflexibility, difficulty with transitions, irritability and ability to hyperfocus (I’m just guessing, you haven’t said this but this is description of the type of adhd that usually comes without attention deficits and rides with asd) would you question that he has it?

No, I wouldn’t. You are right.

Of course that describes one of my kids perfectly, too, yet on paper he looks more typical. I guess what it comes down to is that over the years I have come to value (over value?) neuropsych testing , having seen so many kids misdiagnosed without it (several kids with language based learning differences diagnosed with ADHD and not treated for LD or my own kid’s ADHD missed for so long because of the hyper focus ). So maybe I am assuming that certain common patterns are necessary for diagnosis and I am realizing that they are not. That sometimes observation of symptoms really is enough?

What is your professional background that you are seeing so many misdiagnoses in kids?

I am in education but the kids I am thinking about are extended family, neighbors, friends.

[Anonymous]

Anonymous wrote:Op as previous posters have said - diagnoses are a blunt tool. We don’t have the perfect categories.
What do you and his family see as his major issues - Eg why did they seek a diagnosis?

Yes, appreciate this. And I get that definitions change and also different providers see things differently. I love my nephew and really want to understand him and also want to support my sister, who is devoted but isn't as interested on an intellectual level in some of these details and is happy to let me delve and parse and bring back highlights.

Major issues on one hand depression/anxiety (in a better place lately) and on the other executive function related (disorganization, time management, etc).

[Anonymous]

Anonymous wrote:Russell Barkley has actually talked about how he thinks slow processing speed is a disorder separate from ‘true’ adhd.

Can you recommend a book? I have read one or two of them but probably need a refresher.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I’ve worked with hundreds of kids with autism and other disabilities but a focus on asd. I am not a diagnostician or anything like that but have assisted in clinical testing as part of a multidisciplinary team. However, I’m only going by what you’re saying and don’t know anything about this child so I’m giving a very non-cL inical opinion here. That being said as someone that’s worked with many kids I can definitely see why autism diagnosis was given. Regardless of the diagnosis given though the focus should be more on individual strengths and weaknesses. A good clinician working directly with your kid won’t even need to know the diagnosis beyond what is part of records review, as the program should be individualized and based on specific and ever changing deficits and strengths. They’ll do a thorough records review, interview with parents and caregivers, and observations before even writing a single goal. Or at least the good ones will. If they start working with the child and find other things to be more hindering or some things they thought a kid couldn’t do but can they adjust. Parent training may or may not be a part of the program too, but I always try to add it if parents are receptive. Good programs are always evolving and it always takes time to get to know the individual child and their learning style so give the clinician grace. After a clinician has done all this, and it takes many hours, atthat point an adhd or asd diagnosis doesn’t matter much to the person writing the programs, it ends up being more for insurance billing purposes than anything else. So try not to get too focused on one diagnosis or another because in the long run it really doesn’t matter too much. What matters most is finding someone good to write individualized programs for home-based or school-based services and get those in place sooner than later.

This is the kind of post that really bugs me on this site
What exactly that she said makes you think that is consistent with asd? She didn’t actually describe any symptoms. She mentioned the discrepancy between two scores on the wisc. How does that lead you to ‘definitely see why the autism diagnosis was given’?
I feel like people on this site are so quick to diagnose strangers it’s bananas

If you’d read my entire post you’d see I said I’m not a diagnostician and was only reaffirming what was previously said by op and others. Perhaps you missed the point of my entire message that tests and diagnoses don’t really matter in the grand scheme of things. Diagnostic tools are just tools, a starting point, and the focus should be on the individual strengths and deficits. Individuals matter more than tests and diagnoses and I stand by that.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I’ve worked with hundreds of kids with autism and other disabilities but a focus on asd. I am not a diagnostician or anything like that but have assisted in clinical testing as part of a multidisciplinary team. However, I’m only going by what you’re saying and don’t know anything about this child so I’m giving a very non-cL inical opinion here. That being said as someone that’s worked with many kids I can definitely see why autism diagnosis was given. Regardless of the diagnosis given though the focus should be more on individual strengths and weaknesses. A good clinician working directly with your kid won’t even need to know the diagnosis beyond what is part of records review, as the program should be individualized and based on specific and ever changing deficits and strengths. They’ll do a thorough records review, interview with parents and caregivers, and observations before even writing a single goal. Or at least the good ones will. If they start working with the child and find other things to be more hindering or some things they thought a kid couldn’t do but can they adjust. Parent training may or may not be a part of the program too, but I always try to add it if parents are receptive. Good programs are always evolving and it always takes time to get to know the individual child and their learning style so give the clinician grace. After a clinician has done all this, and it takes many hours, atthat point an adhd or asd diagnosis doesn’t matter much to the person writing the programs, it ends up being more for insurance billing purposes than anything else. So try not to get too focused on one diagnosis or another because in the long run it really doesn’t matter too much. What matters most is finding someone good to write individualized programs for home-based or school-based services and get those in place sooner than later.

This is the kind of post that really bugs me on this site
What exactly that she said makes you think that is consistent with asd? She didn’t actually describe any symptoms. She mentioned the discrepancy between two scores on the wisc. How does that lead you to ‘definitely see why the autism diagnosis was given’?
I feel like people on this site are so quick to diagnose strangers it’s bananas

If you’d read my entire post you’d see I said I’m not a diagnostician and was only reaffirming what was previously said by op and others. Perhaps you missed the point of my entire message that tests and diagnoses don’t really matter in the grand scheme of things. Diagnostic tools are just tools, a starting point, and the focus should be on the individual strengths and deficits. Individuals matter more than tests and diagnoses and I stand by that.

The rest of your post was fine but that bit was not great.
Op hasn’t actually disclosed symptoms until just now. So it was inappropriate and irresponsible to say ‘it sounds like xyz’ even if caveated by ‘I’m not a diagnostician’
We just need to be really careful online bc making wild assumptions based on no info isn’t constructive or helpful

[Anonymous]

Anonymous wrote:

Anonymous wrote:Op as previous posters have said - diagnoses are a blunt tool. We don’t have the perfect categories.
What do you and his family see as his major issues - Eg why did they seek a diagnosis?

Yes, appreciate this. And I get that definitions change and also different providers see things differently. I love my nephew and really want to understand him and also want to support my sister, who is devoted but isn't as interested on an intellectual level in some of these details and is happy to let me delve and parse and bring back highlights.

Major issues on one hand depression/anxiety (in a better place lately) and on the other executive function related (disorganization, time management, etc).

And impulsivity, I should add. Blurting out answers, talking out of turn kind of thing.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op as previous posters have said - diagnoses are a blunt tool. We don’t have the perfect categories.
What do you and his family see as his major issues - Eg why did they seek a diagnosis?

Yes, appreciate this. And I get that definitions change and also different providers see things differently. I love my nephew and really want to understand him and also want to support my sister, who is devoted but isn't as interested on an intellectual level in some of these details and is happy to let me delve and parse and bring back highlights.

Major issues on one hand depression/anxiety (in a better place lately) and on the other executive function related (disorganization, time management, etc).

And impulsivity, I should add. Blurting out answers, talking out of turn kind of thing.

So really at a certain point it’s just about helping him gain greater understanding of himself to try to combat the depression and anxiety. Honestly the best thing she could prob do for him right now is find him a support group or other social group of kids with adhd and asd and see if through that group he can better self identify with a diagnosis that makes it easier for him to understand and navigate

[Anonymous]

And I don’t mean they all have to have both but a mixture of both would be helpful

[Anonymous]

Anonymous wrote:Working memory and processing speed deficits can be associated with adhd but aren’t part of the diagnostic criteria. -a shrink

OP here, thank you. Is the purpose then of the tests use to differentiate what is caused by ADHD vs an LD vs an anxiety disorder? As a professional, do you find it unusual for someone with very poor executive functions to perform average to superior not only in these areas but even in testing that targets executive functions?? Thanks.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Working memory and processing speed deficits can be associated with adhd but aren’t part of the diagnostic criteria. -a shrink

OP here, thank you. Is the purpose then of the tests use to differentiate what is caused by ADHD vs an LD vs an anxiety disorder? As a professional, do you find it unusual for someone with very poor executive functions to perform average to superior not only in these areas but even in testing that targets executive functions?? Thanks.

Not the pp but the purpose is to identify supports
Eg someone with slower processing speed needs different accommodations. Someone with poor working memory may benefit from supports for that etc etc. they can be standalone or happen in tandem with diagnoses but aren’t core symptoms in and of themselves