SPD or ADHD?

[Anonymous]

My son is nearly 5 yrs old and was treated last year by an OT for SPD. She released him from OT after a few months of therapy since he had a pretty mile case and had exceeded the goals she set for him. He has been doing very well in pre-k this year. I met another mom recently whose son has SPD but is 2 yrs older than mine. She said K and 1st grade has been a nightmare for him b/c of the large class size, loud , busy classroom, etc. The teachers said he showed signs on ADHD and recommended testing, etc. I am afraid my son will react the same way when he starts K in the fall at our local public school. His preschool is small (he has about 12 kids in his class) while the classes in ES are large (25 kids). He acts a lot differently at home where it is quiet and not busy/crowded. Has anyone else's child with sensory issues fallen into the same situation once they started ES? I really doubt he has ADHD as he has no issues w/ concentrating, etc at home. He learned to read at age 3, can sit for long periods of time reading and doing mazes, etc. Since SPD is not recognized as a disorder, I can see why schools might mistake it for ADHD. For those people whose kids went through testing for ADHD, is there a questionnaire for parents to fill out about how they behave at home?

[Anonymous]

Before K, our DS was diagnosed with mild SPD and began OT. Like your DS, he showed good concentration and seemed very bright. At the first parent/teacher conference, the teachers had no concerns transition into K but it was clear to us that he had made no progress at all. We talked further to the school and guidance counselor and then formally requested the school to evaluate him for ADHD. They declined because nothing about him stood out. He was friendly, social, engaging - in other words, even though he wasn't learning anything more than what he already knew going into K, because he wasn't a behavioral problem, they decided there wasn't anything wrong. We pursued a private evaluation and, sure enough, he's got ADHD. By this time, the school year was almost over and he still had made no additional progress. But, until we got a medical diagnosis of ADHD, the school wasn't concerned because he was knowledge level was still within "normal" range. That's right, DS had minimal knowledge acquisition in K but because his scores were still within normal, the school did not think there was a problem. After the ADHD diagnosis, it was a totally different story and their opinion changed drastically after that. Go figure.

When DS entered K, we had absolutely no idea that anyone would ever consider him ADHD. What we subsequently have learned is that ADHD people can have excellent concentration and focus - on things they are interested in. It's not an "attention" problem. It's an "inattention" problem relating to things they find boring, repetitive, difficult or challenging. My DS is also not hyperactive. He can sit quietly very easily. However, his is impulsive and when he's bored or working on a challenging task, he does get easily distracted and he gets squirmy.

SPD and ADHD are both neurologial disorders and are frequently co-morbid. Unless you're seeing other signs of ADHD, I think you would be safe taking a wait and see approach to kindergarten. You should keep in mind there are links between SPD and ADHD, learn more about ADHD (www.chadd.org), especially the executive functioning impairments. If some issues come up after he starts K, get him evaluated. Once our DS was qualified for special services, we saw an incredible change in his learning. He's making fantastic progress and we're hopeful that once he gets a good foundation and better understands himself, he will no longer require special services (but will likely still need accomodations). We're immensely grateful that we were able to learn about this before it impacted his confidence and his feelsing about school.

[Anonymous]

Thanks PP for sharing. Is your son in a public or private school? It sounds like public from your description. Can you tell me what type of accommodations he gets in school? Who made the ADHD diagnosis and what was the process like? Thanks.

[Anonymous]

PP here. Our DS is in public school (Fairfax County) but from what I've read in this forum, I don't think it would have made any difference if he were in private school. There might be smaller classrooms to start out with but we can't afford private school and DS is entitled to a free and appropriate education. We did, though, hire a consultant/advocate to help us better understand ADHD and it's impact on DS's education. She also accompanied us to the IEP meeting to make sure it was appropriate for him. She was expensive but we feel we received excellent value and it was still a lot cheaper than private school. We're very happy being in the public school.

DS receives accomodations through his IEP which also spells out the special/related services he receives. A 504 plan would only provide accomodations and isn't as iron clad as an IEP. But, you have to have more documentation to get an IEP. For accomodations, DS gets shortened homework assignments, extra time on any tests, breaks as needed, a wiggle seat, pencil grips, repeated directions, short concise sentences and preferential seating. The key to his success, though, has been services. He gets pull out services 2.5 hrs per day where he receives instruction with no more than 8 kids. He's not getting that instruction the entire time because the kids are at different levels but he is gets a lot more attention than if he were in his regular classroom of 18. As I said before, the difference is amazing. He's working either at or above grade level. I have no idea of your DS has ADHD or not but many of the ADHD kids can get by for several years on their natural intelligence. But, that will only carry them so far. Without intervention, most ADHD kids will hit a wall by the time they're in middle school becuase of the increased academic demands and greater expectations of greater independence - they also start switching classes and teachers every hour.

Our DS was evaluated by Dr. Chuck Conlon and we also participated in an ADHD research study at NIMH (free!). The processes were very similar except at NIMH it was a team (psychiatrist, psychologists and social worker). We had to do a detailed family history and DS was given standardized tests/evaluations and observed. I have to say he really enjoyed it. The goal of these evaluations is to get a true picture of the child and there's a methodology to it. DS was very engaged with both evaluations and actually talks about going back. You can find out more about the ADHD study at http://intramural.nimh.nih.gov/chp/adhd/index.html. It was a very positive experience for us and with both evaluations we not only learned a lot more about our DS, we got great reprots to use in documenting DS's need for services and accomodations. The ADHD researchers have also been really great resources for us when we've had questions.

[Anonymous]

DD has both SPD and ADHD and is struggling in public school K this year. SPD two years ago, and ADHD this summer

I am considering medication as it seems that OT, and classroom modifications (sitting front and center) are not helping much. She is very much struggling.

[Anonymous]

Anonymous wrote:DD has both SPD and ADHD and is struggling in public school K this year. SPD two years ago, and ADHD this summer

I am considering medication as it seems that OT, and classroom modifications (sitting front and center) are not helping much. She is very much struggling.

18:07 here. Does your daughter get any pull out services or just accomodations? I can understand why some would prefer their DC not get pulled out for small group instruction but for us, that's been even more effective than the medication. Don't get me wrong, I'm not at all opposed to medication. We're still trying to find the right one and the right dose for DS but even without an effective medication, he's not been struggling academically like he did last year - because of the small group instruction.

[Anonymous]

My DS was diagnosed with ADHD in kindergarten. It is done through a questionnaire or through neuropsych testing. Obviously, the neuropsych testing is much more accurate, but it isn't done by the school and isn't covered by many insurances.

There are two questinnaires that I am aware of that are used to diagnose ADHD. The school used the Conner and my pediatrician used the Vanderbilt. After getting the ADHD diagnosis, I wasn't quite on board even though my input was consistent with the diagnosis. So, I had neuropsych testing done and it turns out he has a sensory processing disorder, which is what I had suspected.

In the end, I'm not sure that the diagnosis will make any difference at all with respect to my DS's school experience. We already get services and accommodations through the school, which when necessary has included small group instruction. And, FWIW, our accommodations don't include sitting front and center because that didn't work with my DS either.

[Anonymous]

12:10 provided a fabulous response. I agree with all points and add for emphasis that SPD and ADHD are indeed often intertwined ... SPD is just an early indicator of ADHD in many but certainly not all cases. Smaller class size and teachers who are willing to user shorter, simpler, and repeated-as-needed instructions is very helpful, but often is not enough. Pull-out classes really do the trick for some and medication is often extremely helpful for most (but again, certainly not needed for all.)

The child with ADHD-inattentive is often overlooked in the classroom in terms of needing support because they tend to be very able to sit still (unlike their hyperactive buddies) and their reduced ability to learn new material is less obvious until around the third grade or so ... as prior posters have said, their innate abilities and the lower demands of the early years can mask the problem. Then they seemingly "suddenly" hit a wall that should have been seen coming years before and hopefully headed off before damage is done to their knowledge, skills, and of course self-esteem and love of school.

I also really agree with the thought that ADHD-inattentive does NOT mean children cannot focus ... when they are really interested in something they can focus to the point of preoccupation ... they can't turn off their focus on one thing in order to focus on another ... in particular, what is going on in the classroom or in the case of social interactions, what a playmate is trying to convey. This is why social problems also occur, not just academic problems.

[Anonymous]

OP again. Thanks for everyone's responses. Does anyone's child get any special services for SPD? I was told by my child's OT that since there is no diagnosis yet for SPD that these kids often get overlooked or denied for any special services. She said some parents then seek an ADHD diagnosis just to get their child help in school.

[Anonymous]

Anonymous wrote:OP again. Thanks for everyone's responses. Does anyone's child get any special services for SPD? I was told by my child's OT that since there is no diagnosis yet for SPD that these kids often get overlooked or denied for any special services. She said some parents then seek an ADHD diagnosis just to get their child help in school.

It's not the diagnosis that gets the kid services, it's the impact on their learning. When SPD is perceived as having an impact on education, it's generally addressed through accomodations. As PPs have stated, SPD is often diagnosed before ADHD is. That doesn't mean the ADHD isn't there, it just wasn't recognized earlier. If you think SPD is impacting your child in school, I think you should consider having an evaluation by a developmental pediatrician. As PPs have said, many (but not all) kids with SPD are later found to have other issues. Getting an early diagnosis really makes a big difference, especially if you want the school to provide services. Even with a diagnosis, it's not always easy to get. Good luck!

[Anonymous]

But SPD isn't actually a diagnosis recognized by physicians (yet) so if I tell the school about the SPD which was the diagnosis his OT gave him, will they even recognize it? I know ADHD is a diagnosis. My friends teach in public schools and tell me that parents can talk until they are blue in the face but until there is an actual diagnosis that the schools recognize (like ADHD) then the student cannot receive services. They've told me the process to get accommodations through an IEP can take a VERY long time so what happens to the student in the mean time?

[Anonymous]

I don't think you're understanding the eligibility process. SPD is absolutely recognized in the academic world as a disability. But, in order to receive services, your child has to be categorized as disabled in two of the categories defined in this link and those disabilities have to have an impact on his learning.

http://www.fcps.edu/dss/sei/speddisb.htm#list

You get services through the IEP process. Accomodations are done through either an IEP or a 504. A 504 is much easier to get. It's important to know the difference between the two.

Having the disability by itself doesn't qualify you. It must impact have an educational impact. You'll note that under the category of Other Health Impairment, it includes "alertness......and...a heightened alertness to environmental stimul". That would include SPD. In fact, you don't even have to have it officially diagnosed, the child just has to be considered by the committtee to have it. My DS qualifies under Other Health Impairment (ADHD) and Specific Learning Disability. Under OHI, his ADHD affects his alertness and ability to attend. He doesn't actually have a real learning disability but because the ADHD affects his executive functioning and working memory, he is considered to have a learning disability. His ADHD actually qualifies him as disabled in two categories. But, not everyone with ADHD needs special services. Some just need accomodations.

I agree with your friends that it can be difficult to get services, even with a diagnosis. That's why it's important to know the law and the processes. The FCPS website has good resources on this http://www.fcps.edu/specialed.htm as does Wrights Law www.wrightslaw.com.

[Anonymous]

Thanks PP for all of the great information. My DS most definitely has a heightened state of alertness to environmental stimuli which absolutely affects him negatively in the classroom. I will save the info and the link for further reference.

[Anonymous]

I have a SPD child who is in kg and having the hardest time concentrating. There are 18 kids in his class. His private school will not provide accommodations for him. They do not provide OT on premises, even if I offer to pay for it. They will not allow an aid to help him in class either regardless if I pay for it. They want him out of their school. And his is a mild case.

If I put him in public school, however, (I live in Fairfax county) can I pull him out daily for therapy? Will Fairfax COunty allow that, does anyone know? Being in school 7 hours a day would be so hard on him.

[Anonymous]

Anonymous wrote:I have a SPD child who is in kg and having the hardest time concentrating. There are 18 kids in his class. His private school will not provide accommodations for him. They do not provide OT on premises, even if I offer to pay for it. They will not allow an aid to help him in class either regardless if I pay for it. They want him out of their school. And his is a mild case.

If I put him in public school, however, (I live in Fairfax county) can I pull him out daily for therapy? Will Fairfax COunty allow that, does anyone know? Being in school 7 hours a day would be so hard on him.

I take my ADD/SPD DD to therapy after school. The school offers her OT for handwritting/fine motor skills delays that effect her classroom performance. I do not think that the quality is as great as private hence still maintaining our OT.

The teachers seem sensitive, and allow her to sit on a sit a disc which helps. I'd also suggest an ADHD test as they are often co-morbid diagnosis