Twice Exceptional

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:We are concerned about meds because of her history of anxiety. She has been managing fine at school - she can focus with no issues when she is interested and with little prompting when not. At this point we will definitely not take anything off the table but I have some serious reservations about medication. It’s good to hear stories about how it has been helpful, though hard to know if the kids are similar to her and I’d also be curious what meds and what the side effects are.

A lot of kids have both ADHD and anxiety. Commonly this is treated with stimulants plus an antidepressant. That is what my kid takes, plus clonidine, which reduces hyperactivity. She has severe combine type ADHD, so we have no choice but to medicate. Main side effects of the stimulants is loss of appetite, but she has normal height and weight, so she is eating enough overall. No side effects from the antidepressant.

Sometimes doctors use Strattera, which works for both ADHD and anxiety.

Thank you! Medication wasn’t recommended as a first course of treatment. How do we know what severity her adhd is?

What kind of test did the evaluator use to diagnose ADHD? For DC, a TOVA was used and you could see the severity in the test results.

[Anonymous]

They did a ton of tests - but not the TOVA from what I can tell.

Clinical Evaluation of Language Fundamentals-5 (CELF-5) Gray Oral Reading Test-5 (GORT-5)
Rorschach Inkblot Test
Test of Written Language (TOWL)
Thematic Apperception Test (TAT)
Wechsler Individual Achievement Test-III (WIAT-III)
Wechsler Intelligence Scale for Children-V (WISC-V)
Wide Range Assessment of Memory and Learning -2 (WRAML-2) Wide Range Assessment of Visual Motor Abilities (WRAVMA) Woodcock Johnson Tests of Academic Achievement-III (WJ-III)

Her working memory was 95%ile
Her processing speed was 50%ile

She scored lowest by far in coding, at 16%ile (which still
Put her at low average), but 84% in the symbol search, the other component of the processing speed, so the much lower score brought it down overall. Her fluid reasoning was in the mid-80 percentiles.

Her academic skills were all assessed at or above grade level, especially reading comprehension (12th grade) and vocabulary (8th). Her math was more uneven - she tested at grade level for the easier stuff which she rushed and made small errors, but almost 6th grade for harder problem solving.

The biggest issue seems to be her attention, it causes her to absorb knowledge unevenly and have problems with remembering. Is this the type of thing that is possible to learn or are we absolutely looking at medication here, at least eventually? z

[Anonymous]

Anonymous wrote:They did a ton of tests - but not the TOVA from what I can tell.

Clinical Evaluation of Language Fundamentals-5 (CELF-5) Gray Oral Reading Test-5 (GORT-5)
Rorschach Inkblot Test
Test of Written Language (TOWL)
Thematic Apperception Test (TAT)
Wechsler Individual Achievement Test-III (WIAT-III)
Wechsler Intelligence Scale for Children-V (WISC-V)
Wide Range Assessment of Memory and Learning -2 (WRAML-2) Wide Range Assessment of Visual Motor Abilities (WRAVMA) Woodcock Johnson Tests of Academic Achievement-III (WJ-III)

Her working memory was 95%ile
Her processing speed was 50%ile

She scored lowest by far in coding, at 16%ile (which still
Put her at low average), but 84% in the symbol search, the other component of the processing speed, so the much lower score brought it down overall. Her fluid reasoning was in the mid-80 percentiles.

Her academic skills were all assessed at or above grade level, especially reading comprehension (12th grade) and vocabulary (8th). Her math was more uneven - she tested at grade level for the easier stuff which she rushed and made small errors, but almost 6th grade for harder problem solving.

The biggest issue seems to be her attention, it causes her to absorb knowledge unevenly and have problems with remembering. Is this the type of thing that is possible to learn or are we absolutely looking at medication here, at least eventually? z

. None of those, at least in my experience with my child, were used to diagnose ADHD. In my DC’s case, they were used to determine his IQ and LDs. Except for TAT, DC never had that. The Connrs and TOVA were the tests used for my DC.

[Anonymous]

OP- when my son was diagnosed, they literally hooked him up to computer with electrodes and read his attention span, impulsivity, etc. I think it's an EEG (?). The psychologist did this along with a lot of other data and testing criteria. Not only was the whole thing helpful in diagnosis, but they were able to track *how* ADHD might play out for him. For instance, my DS has enormous difficulty regulating his attention to start a task- once he's attending his attention span is well above average. By enormous difficulty, I mean that he needs support to begin tasks, even at almost twelve- he can barely function independently to start homework or projects. He's the kid who takes 30 minutes to unpack a backpack or organize his work- he argues and procrastinates. As a 2e kid, he spends twice the amount of time organizing and starting as he does completing assignments. The computer hookup showed us this issue- we knew to expect it when he was quite young.

[Anonymous]

Anonymous wrote:OP- when my son was diagnosed, they literally hooked him up to computer with electrodes and read his attention span, impulsivity, etc. I think it's an EEG (?). The psychologist did this along with a lot of other data and testing criteria. Not only was the whole thing helpful in diagnosis, but they were able to track *how* ADHD might play out for him. For instance, my DS has enormous difficulty regulating his attention to start a task- once he's attending his attention span is well above average. By enormous difficulty, I mean that he needs support to begin tasks, even at almost twelve- he can barely function independently to start homework or projects. He's the kid who takes 30 minutes to unpack a backpack or organize his work- he argues and procrastinates. As a 2e kid, he spends twice the amount of time organizing and starting as he does completing assignments. The computer hookup showed us this issue- we knew to expect it when he was quite young.

Op / that sounds pretty cool. I know my dd did not experience that. We had a private evaluation with a highly recommended psychologist. We wanted it done before summer and the wait time for any of the clinics was too long. We aren’t in the DC area but there were also lots of options here. We went with someone who’s also knows her school well, as we went to be sure her highly unusual school will continue to be a good fit for her.

[Anonymous]

Anonymous wrote:They did a ton of tests - but not the TOVA from what I can tell.

Clinical Evaluation of Language Fundamentals-5 (CELF-5) Gray Oral Reading Test-5 (GORT-5)
Rorschach Inkblot Test
Test of Written Language (TOWL)
Thematic Apperception Test (TAT)
Wechsler Individual Achievement Test-III (WIAT-III)
Wechsler Intelligence Scale for Children-V (WISC-V)
Wide Range Assessment of Memory and Learning -2 (WRAML-2) Wide Range Assessment of Visual Motor Abilities (WRAVMA) Woodcock Johnson Tests of Academic Achievement-III (WJ-III)

Her working memory was 95%ile
Her processing speed was 50%ile

She scored lowest by far in coding, at 16%ile (which still
Put her at low average), but 84% in the symbol search, the other component of the processing speed, so the much lower score brought it down overall. Her fluid reasoning was in the mid-80 percentiles.

Her academic skills were all assessed at or above grade level, especially reading comprehension (12th grade) and vocabulary (8th). Her math was more uneven - she tested at grade level for the easier stuff which she rushed and made small errors, but almost 6th grade for harder problem solving.

The biggest issue seems to be her attention, it causes her to absorb knowledge unevenly and have problems with remembering. Is this the type of thing that is possible to learn or are we absolutely looking at medication here, at least eventually? z

This is a difficult question to answer. ADHD kids CAN pay focus, but they need more redirection and coaching than other kids. You can see how she does and take it from there.

[Anonymous]

Anonymous wrote:OP- when my son was diagnosed, they literally hooked him up to computer with electrodes and read his attention span, impulsivity, etc. I think it's an EEG (?). The psychologist did this along with a lot of other data and testing criteria. Not only was the whole thing helpful in diagnosis, but they were able to track *how* ADHD might play out for him. For instance, my DS has enormous difficulty regulating his attention to start a task- once he's attending his attention span is well above average. By enormous difficulty, I mean that he needs support to begin tasks, even at almost twelve- he can barely function independently to start homework or projects. He's the kid who takes 30 minutes to unpack a backpack or organize his work- he argues and procrastinates. As a 2e kid, he spends twice the amount of time organizing and starting as he does completing assignments. The computer hookup showed us this issue- we knew to expect it when he was quite young.

This is so interesting to me. How are you supporting DS for schoolwork? We are considering an executive function. coach because DC is so bright yet cannot get organized or begin work well at all.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP- when my son was diagnosed, they literally hooked him up to computer with electrodes and read his attention span, impulsivity, etc. I think it's an EEG (?). The psychologist did this along with a lot of other data and testing criteria. Not only was the whole thing helpful in diagnosis, but they were able to track *how* ADHD might play out for him. For instance, my DS has enormous difficulty regulating his attention to start a task- once he's attending his attention span is well above average. By enormous difficulty, I mean that he needs support to begin tasks, even at almost twelve- he can barely function independently to start homework or projects. He's the kid who takes 30 minutes to unpack a backpack or organize his work- he argues and procrastinates. As a 2e kid, he spends twice the amount of time organizing and starting as he does completing assignments. The computer hookup showed us this issue- we knew to expect it when he was quite young.

This is so interesting to me. How are you supporting DS for schoolwork? We are considering an executive function. coach because DC is so bright yet cannot get organized or begin work well at all.

One thing I have learned the hard way is to front load homework with an enjoyable activity instead of the other way (keeping the fun activity for the end). Starting with 2 minute mysteries, a short logic puzzle, riddle, etc. warms up his brain. It was hard because I'm a veggies before dessert parent, but trying to engage DS when his dopamine levels are low is a battle. It's almost better for his particular case to put the harder, less enjoyable work toward the end and start with a fun activity followed by the easier, more enjoyable homework.
Telling a kid with EF issues that after they do the hard, tedious work of organizing that they will be immediately jumping into a grammar assignment is going to cause a struggle.

[Anonymous]

Thanks. We're still at the struggling point.

[Anonymous]

Anonymous wrote:

Anonymous wrote:They did a ton of tests - but not the TOVA from what I can tell.

Clinical Evaluation of Language Fundamentals-5 (CELF-5) Gray Oral Reading Test-5 (GORT-5)
Rorschach Inkblot Test
Test of Written Language (TOWL)
Thematic Apperception Test (TAT)
Wechsler Individual Achievement Test-III (WIAT-III)
Wechsler Intelligence Scale for Children-V (WISC-V)
Wide Range Assessment of Memory and Learning -2 (WRAML-2) Wide Range Assessment of Visual Motor Abilities (WRAVMA) Woodcock Johnson Tests of Academic Achievement-III (WJ-III)

Her working memory was 95%ile
Her processing speed was 50%ile

She scored lowest by far in coding, at 16%ile (which still
Put her at low average), but 84% in the symbol search, the other component of the processing speed, so the much lower score brought it down overall. Her fluid reasoning was in the mid-80 percentiles.

Her academic skills were all assessed at or above grade level, especially reading comprehension (12th grade) and vocabulary (8th). Her math was more uneven - she tested at grade level for the easier stuff which she rushed and made small errors, but almost 6th grade for harder problem solving.

The biggest issue seems to be her attention, it causes her to absorb knowledge unevenly and have problems with remembering. Is this the type of thing that is possible to learn or are we absolutely looking at medication here, at least eventually? z

. None of those, at least in my experience with my child, were used to diagnose ADHD. In my DC’s case, they were used to determine his IQ and LDs. Except for TAT, DC never had that. The Connrs and TOVA were the tests used for my DC.

Not an expert but I recognize a chunk of those tests as geared towards a dyslexia or language processing evaluation. CELF, GORT, and TOWL specifically.

[Anonymous]

Have you ruled out a visual processing disorder? The low coding score could suggest some kind grapho-motor deficit. I wouldn’t necessarily jump to ADHD. Not sure about which test you have that confirms ADHD. Or if you are going off behavior alone.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP- when my son was diagnosed, they literally hooked him up to computer with electrodes and read his attention span, impulsivity, etc. I think it's an EEG (?). The psychologist did this along with a lot of other data and testing criteria. Not only was the whole thing helpful in diagnosis, but they were able to track *how* ADHD might play out for him. For instance, my DS has enormous difficulty regulating his attention to start a task- once he's attending his attention span is well above average. By enormous difficulty, I mean that he needs support to begin tasks, even at almost twelve- he can barely function independently to start homework or projects. He's the kid who takes 30 minutes to unpack a backpack or organize his work- he argues and procrastinates. As a 2e kid, he spends twice the amount of time organizing and starting as he does completing assignments. The computer hookup showed us this issue- we knew to expect it when he was quite young.

This is so interesting to me. How are you supporting DS for schoolwork? We are considering an executive function. coach because DC is so bright yet cannot get organized or begin work well at all.

One thing I have learned the hard way is to front load homework with an enjoyable activity instead of the other way (keeping the fun activity for the end). Starting with 2 minute mysteries, a short logic puzzle, riddle, etc. warms up his brain. It was hard because I'm a veggies before dessert parent, but trying to engage DS when his dopamine levels are low is a battle. It's almost better for his particular case to put the harder, less enjoyable work toward the end and start with a fun activity followed by the easier, more enjoyable homework.
Telling a kid with EF issues that after they do the hard, tedious work of organizing that they will be immediately jumping into a grammar assignment is going to cause a struggle.

NP. this is familiar to us as well. DS is a rising 5th grader. He's very "cerebral" and enjoys all kind of puzzles but hates rote work. Shocking, right? He responds well to having a fun mental challenge to warm up and timed breaks. We haven't started an ADHD coach yet, but I'm guessing we'll be looking at that in MS. Right now we're just finishing up with academic language therapy for his dyslexia where he shot through his teacher's curriculum like a rocket. I've noticed her routine with him is to start with typing. She has a program where he types for a period of time and it tracks his speed and accuracy and compares it against his history. It works very well as a transition because it's quiet, independent work where he's in competition with himself and he sees constant improvement. She puts his most challenging element, handwriting, towards the end of the session but not last.

[Anonymous]

Anonymous wrote:My dd is 8, just finished first grade and we just did a neuropsych evaluation of her. We have learned that she is extremely smart and also has an attention disorder. We don’t have the final report yet but this is what the psychologist explained. I was speaking with a friend who has older kids and she told me this is called Twice Exceptional. I hadn’t heard that term and wonder what others who have kids who are twice exceptional might be able to share?

My DS has ADHD-inattentive, some reading processing & tests 'gifted.' Similar experience to some others where the gaps between where he has some deficits/limits and what where he is on areas of strength are even more noticeable, pronounced, and frustrating for him. I think the biggest value of having the testing done is to be able to recognize how you can help provide support in the areas needed - for the areas where the are challenged and to not be held back in the areas where they can excel. Doing the neuropsych testing was invaluable for being able to understand how to support my kid, and also how to make him understand his brain works in certain ways, where he might have to learn xx differently than some kids (in both ways) which helps get out of the 'i'm stupid' etc trap to some degree. I also have a husband who is bright (ie. tested 'gifted' as a child) and has ADD, and grew up in an era without all the recognition or potential accommodations -- and I'd say the best thing you can do to help a kid with ADD is to work on managing some levels of organization, routine, and mindfulness.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My dd is 8, just finished first grade and we just did a neuropsych evaluation of her. We have learned that she is extremely smart and also has an attention disorder. We don’t have the final report yet but this is what the psychologist explained. I was speaking with a friend who has older kids and she told me this is called Twice Exceptional. I hadn’t heard that term and wonder what others who have kids who are twice exceptional might be able to share?

My DS has ADHD-inattentive, some reading processing & tests 'gifted.' Similar experience to some others where the gaps between where he has some deficits/limits and what where he is on areas of strength are even more noticeable, pronounced, and frustrating for him. I think the biggest value of having the testing done is to be able to recognize how you can help provide support in the areas needed - for the areas where the are challenged and to not be held back in the areas where they can excel. Doing the neuropsych testing was invaluable for being able to understand how to support my kid, and also how to make him understand his brain works in certain ways, where he might have to learn xx differently than some kids (in both ways) which helps get out of the 'i'm stupid' etc trap to some degree. I also have a husband who is bright (ie. tested 'gifted' as a child) and has ADD, and grew up in an era without all the recognition or potential accommodations -- and I'd say the best thing you can do to help a kid with ADD is to work on managing some levels of organization, routine, and mindfulness.

And, just to note also as some others have, testing 'gifted' doesn't automatically translate into some markers of success or achievement, just like ADHD is not a 'sentence' of any kind.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My dd is 8, just finished first grade and we just did a neuropsych evaluation of her. We have learned that she is extremely smart and also has an attention disorder. We don’t have the final report yet but this is what the psychologist explained. I was speaking with a friend who has older kids and she told me this is called Twice Exceptional. I hadn’t heard that term and wonder what others who have kids who are twice exceptional might be able to share?

My DS has ADHD-inattentive, some reading processing & tests 'gifted.' Similar experience to some others where the gaps between where he has some deficits/limits and what where he is on areas of strength are even more noticeable, pronounced, and frustrating for him. I think the biggest value of having the testing done is to be able to recognize how you can help provide support in the areas needed - for the areas where the are challenged and to not be held back in the areas where they can excel. Doing the neuropsych testing was invaluable for being able to understand how to support my kid, and also how to make him understand his brain works in certain ways, where he might have to learn xx differently than some kids (in both ways) which helps get out of the 'i'm stupid' etc trap to some degree. I also have a husband who is bright (ie. tested 'gifted' as a child) and has ADD, and grew up in an era without all the recognition or potential accommodations -- and I'd say the best thing you can do to help a kid with ADD is to work on managing some levels of organization, routine, and mindfulness.

And, just to note also as some others have, testing 'gifted' doesn't automatically translate into some markers of success or achievement, just like ADHD is not a 'sentence' of any kind.

Exactly- I think it's important to stay balanced and humble- I recall being very focused on my son's intellect when he was younger because his academic/intellectual milestones were out there by years. Over time, I have learned that there are a lot of indicators of success- diligence, follow through, emotional and social intelligence, resilience and taking intellectual risks, etc. Peers who are exceptionally bright but probably don't have DS's intellectual gifts but possess these critical qualities and are smart enough to achieve what they want to on top of it- strike me as highly capable. It's given me a new appreciation of how intellect is one influencer of success-- but how my son would have benefited equally, perhaps more, from a stronger social/emotional or twice exceptional program at school.
There was even a recent thread where a mom asked why her son wasn't invited to the gifted program at his school, and she listed his qualities of maturity, confidence, and leadership-- while these qualities don't indicate intellectual gifts, it amazed me how dismissive other parents were of personal traits that will take this kid far in life. When child *is* intellectually gifted, but struggles with these other skills, it's abundantly clear how important these other skills are- soapbox, I know, but some perspective on twice exceptional.