<p>
That’s exactly what happens. It’s called compensating, but it stops doing the trick as work gets more sophisticated and demanding and kids have to juggle multiple high level courses as well as EC’s.</p>
<p>I think that ADHD - inattentive type often goes undiagnosed, regardless if a child is gifted or not. Often the signs of ADHD - inattentive type can be subtle, so they may go unnoticed by parent or teacher. The ADHD - hyperactive type is easier to spot (and may be overdiagnosed given requirements at school to stay quiet and in seat during school lectures).</p>
<p>As per DSM4 and previous poster, ADHD must affect 2 area of life. For school, that does not necessarily mean getting Cs. It can mean: forgeting to bring required items (books, pencils, HW) to class, doing HW but forgetting to turn it in, zoning out.</p>
<p>Interesting what you say about difficulty of diagnoising inattentives. My friend has a kid with ADHD and is a school speech therapist. She told me about a very sweet girl she was seeing who was not doing well in school. My friend raised the question regarding ADHD to the teacher and the teacher, who my friend respected wrote this possibility off. Then my friend sat in on the class to observe the girl. She spotted all of the quiet things the girl was doing when the teacher was speaking that was clearly not listening. She brought this to the teacher’s attention and the teacher admitted that she had never noticed any of it. I’m sure that when you are responsible for a large class you notice the disruptons but maybe not the kid who is looking off in another direction or spacing out. The girl was eventually diagnosed as inattentive.</p>
<p>“I’m sure that when you are responsible for a large class you notice the disruptons but maybe not the kid who is looking off in another direction or spacing out.”</p>
<p>Sometimes you can’t even notice the disruptions until they are egregious. I remember once being the piano accompanist for a 3rd grade class program. We were rehearsing, it wasn’t even a very large class, the teacher was also there, and I was trying (when not playing) to watch an ADHD boy to see when he was going off track or about to do something. Maybe I thought I could head him off, or at least observe something that would be helpful. Anyway, EVERY TIME I was watching, he was sitting quietly. And then seconds later, he’d be sprawled on the floor in a weird position, or on the other side of the room, or something. Never could I catch him in the act. It was weird.</p>
<p>Maybe my attention span was slightly shorter than his? :D</p>
<p>Yes, in attentives don’t cause class disruptions so teachers often don’t notice. For my S, 2 of 6 teachers Were very organized and emailed me about instances such as the following:</p>
<p>S hadn’t turn in major essay but I had physically seen him pack essay into backpack the night before. Yes, didn’t turn it in and didn’t “hear” teacher request to turn it in and didnt “notice” everyone else turning it in, didn’t think to “ask” about turning in the major assignment etc. many teachers might not notice this behavior and many might not take the time to email the parent so that parent knows what is happening after they see the essay so carefully loaded in the backpack. </p>
<p>This is at a private school so 15 kids per class and even then not all teachers noticed. It must be nearly impossible to notice in a class of 30.</p>
<p>This discussion has me thinking my 20-year old is an “inattentive.” He’s very bright and never had any trouble in school or college, but socially, he just doesn’t know what’s going on sometimes. I used to be the same way but I think I eventually learned to pay attention/read social cues. Not sure if it’s a lack of curiousity or zoning out. Everyone else knows what’s going on but he doesn’t. And he doesn’t ask questions that would be obvious to me, to fill in the blanks in his understanding of the situation.</p>
<p>Sigh.</p>
<p>This also illustrates how some children just learn differently and need to be “engaged” or hands-on for learning to happen. A teacher in the front of the room droning on is an invitation to inattention! It just happens quicker for some kids than others. :)</p>
<p>So true about different learning styles. I’m a Kinesthetic learner with difficulty as a pure auditory learner. I also had ADHD - hyperactive type with impulsivity control, (no meds, parents refused) but again the hyperactive type fades as one ages.</p>
<p>I urge those of you who wonder how reasonable people could have such different views on this, read the links from the “the project” in post 64. Be aware that unlike Hallowell’s stuff, this is a proffessional , presumablly peer reviewed publication. It IS a harder read, but you don’t have to be gifted to get through it. (smile).</p>
<p>I just wanted to add that just because a student in 10th grade is a straight A student and may indeed turn out to be diagnosed with ADD, it does not mean that grades will not slip in the future. As others have mentioned, gifted students with ADD are usually able to manage their work despite the ADD for some time. But, sometimes they have increasing difficulty with concentrating, etc. as the course material/load becomes more difficult. All the more reason to get a diagnosis, if indeed it should be determined there is one, so that if difficulty should arise in the future you will be prepared.</p>
<p>“Be aware that unlike Hallowell’s stuff, this is a proffessional , presumablly peer reviewed publication” </p>
<p>Shrinkwrap -Why do professionals feel the need to scoff at Hallowell’s stuff? His intended audience is not the learned few yearning for peer reviewed, heavy material. (Side bar - I do think professionals should read mainstream books, just to be in touch with the patients and families . I read 4th grade books when my kids were that age- it allowed more insightful conversation.) Hopefully you won’t be offended by the question, I’ve wondered about this for several years now. </p>
<p>Hollowell books have opened the eyes of many potentially ADHD patients, giving them incentive to consult a professional opinion. In some ways they may be more Dear Abby than Real News… but like Dear Abby the scenarios get people thinking and talking.</p>
<p>^ I think the goals of peer reviewed and professional literature have different goals. I think professionals view the goal of books written for lay readers as selling books. If you sell enough books, you can sway how medicine is practiced. Hollowell’s books sell. It might not be a good thing to have medicine change the way it is practiced with little or no science behind it. It happens because it is often easier to agree then to disagree, especially if you are being put in a position to treat patients you were not trained to treat. But maybe it will be fine. We shall see.</p>
<p>And I have Hollowell’s books, at least the early ones, and visit his site as well. It is not uncommon for someone to read his books and weep. “That’s me!”. Everyone seems to have that response. Everyone. </p>
<p>And I have “The bipolar Child”, written by one of my attending s, and more recently “Your Child is Not Bipolar!”.</p>
<p>"Hopefully you won’t be offended by the question, I’ve wondered about this for several years now. "</p>
<p>I didn’t see this part at first, and it gave me pause. I hate to muck up the OP’s thread with this, because it is surely off topic, but if I was offended, it would be becuase some lay books really seem to trivialize the complexity of mental health in general, and psychiatry in particular. I could be wrong, but I bet few folks read lay books about neurological or hematology topics, nor feel in the position to recommend how an assessment should be done, or what diagnosis should be looked for. I know it happens, but not nearly as much as it does with psychiatry, nor with as much conviction. </p>
<p>but perhaps that is for another thread. Again, if you have not, take a look at the link.</p>
<p>^^this. It’s a shame that the recommendation to the OP to have her daughter evaluated (holistically) seems have disappeared into page 1 and the OP seems to be going down the ADHD path.</p>
<p>Thanks for the answer, Shrinkwrap. I liked it lots better than the “I don’t read pop psychology” answer that stressed me in the past. Apologies for the thread detour.</p>
<p>I had a similar experience with my S. He specifically asked why he had not been evaluated for ADD. I took him to our GP with that question and eventually had him evaluated by a psychologist. As I understood it, the psychologist’s evaluation was not just specific to ADD but was a broad spectrum assessment that involved interviewing my son both with and without me present and specific testing. I assumed that even if you go in asking about ADD when a professional assesses it is their job to look at the big picture. Is that not protocol?</p>
<p>Seahorses: I have understood from the OP that the suspicion of ADD wasn’t just hatched when the daughter asked the question. It just took that question for her to consider acting.</p>
<p>" I assumed that even if you go in asking about ADD when a professional assesses it is their job to look at the big picture. Is that not protocol?"</p>
<p>It depends on who you ask, and who is paying.</p>
<p>In the link I’ve referenced, if the investigators used what THEY considered the impairment criteria, more kids WITHOUT adhd where “treated”, then kids WITH adhd.</p>
<p>^^^Shrinkrap can you elaborate</p>
<p>Perhaps better on another thread. And later. I’m on a REAL treadmill right now. But it’s in the link.</p>
<p>As I posted earlier, I am concerned about the level of stress that OP’s daughter is under and I am also concerned about premature closure. I do not at all doubt that OP has her daughter’s best interests at heart and I hope that she gets the evaluation and help that she needs. </p>
<p>Having said that, I have to say that my experience as a pediatrician suggests that the diagnosis of ADD/ADHD is anything by systematic and consistent. I know psychologists who use the same evaluative procedures and come to different conclusions: some who nearly always diagnose ADD/ADHD and some who rarely diagnosis it. I know neurologists and pediatricians who make the diagnosis on the basis of one interview with patient and parent. I have had many patients ‘self diagnose’ themselves at age 17 or 18, some after experimental use of stimulant medications ‘borrowed’ from friends, with no history of attentional problems.</p>
<p>I am very concerned about the over-use of such powerful medicines. I am also concerned about the numbers of children who do not get appropriate evaluation and treatment.</p>
<p>ADD without hyperactivity is difficult to diagnose. ADD with hyperactivity can be too easy to diagnose. The packet of questionnaires is biassed in favor of ADHD and is less effective in identifying inattentive ADD. In many cases teachers who have already identified a student as hyperactive are asked to fill out a questionnaire that too easily confirms their suspicions. On the other hand, well-behaved children, especially girls, may get the benefit of the doubt.</p>
<p>The problem with premature closure is that other, more important diagnoses may be missed. For example children with dyslexia or auditory processing disorder may be unable to attend to their classroom assignments and may be fidgety and restless. Another example might be a child who is stressed or depressed and finds her attention wandering. It would be, in fact it is all too commonly, a shame to miss the real problem and medicate a child who really needs his or her real problem addressed.</p>
<p>For full disclosure, I should say that I have a son with Asperger’s Syndrome who was mistakenly diagnosed with ADHD, and therefore I am perhaps too sensitive to the problem of premature closure. On the other hand, as a physician, I know too well from experience with other patients the real dangers of this problem.</p>