ADHD is a very real medical condition that should only be diagnosed by a reputable licensed physician in a session lasting more than 5 minutes and only after a serious discussion with the parents.
ADHD has a high co-morbidity rate with dyslexia.
Starting in 2nd grade, which for the record was also my son’s first year in public school, his teachers started telling me that they were concerned with his ability to focus. Now, as you well know, my son is dyslexic and so I don’t easily go to a place of understanding where people can challenge his ability to focus. That being said, when it comes to his teachers, I always endeavor to hear them out.
Our private tutor who works with him on his dyslexia therapy and I were discussing the teacher’s concerns and she stated that she came to realize he would fidget, talk more, try to distract her off topic when he was scared of the material in front of him, when he felt it was too hard. It was a powerful deflection technique and since he’s so fun to talk to and is always lit up about what he’s choosing to talk to you about, it’s both easy yet challenging to engage in the conversation.
When he moved into third grade I was set up by the school principal and teachers and blind sided by an ADHD conversation. I was at the school for a 504 meeting as that’s what we had at the time, having already filed for an FIE and started that whole process, and I had hired an advocate who attended the meeting with me. The school principal asked the teachers during the meeting if they had any concerns about my son’s behavior and they all looked at him with big doe eyes and started shaking their heads dramatically and saying they had grave concerns about his focus.
I was instantly furious, but kept my cool.
The principal acted like his teachers concerns were the first he’d ever heard of them. He acted sympathetic and surprised. The teachers expressed their grave concerns for my son’s inability to focus. I wanted to tell them all that they were not good actors, but I still kept my mouth shut.
As I had filed for the FIE and had already signed the paperwork to begin the process, the vice principal asked if I wanted to include ADHD in their evaluation by their LSSP, which the advocate vocally encouraged, so I agreed.
We walked out of the meeting and I blew up. I was so angry at the blindside and having to give into their request, just to shut them up. I was adamant that my child was not ADHD and that his behaviors were born out of fear.
Of course the LSSP recommendation said all over it that she strongly felt he was ADHD which his teachers scores agreed with, but my scores did not. I sent the report to our pediatrician and he called me late one evening and we spoke for an hour. He agreed with me quite strongly that my son was not ADHD. He also said he’s not quick to throw out the diagnosis of ADHD too quickly and that it’s important that the schools and parents be aligned in the diagnosis, and in our case not only was I not aligned, but in his opinion, their insistence of ADHD just showed their complete ignorance of dyslexia, which he quickly said he hated to say.
I have to say, I adore our pediatrician. The man just gets it!
Fast forward to the end of the year and it’s recommended to me by a friend of mine that since the LSSP has said she feels strongly that he’s ADHD, that I need our pediatrician to write a letter stating that he’s not, which I request, which he writes, and I hand carry to the school for inclusion in his school file, where it still sits.
Fast forward to the summer, you know, the one that just ended though it’s still August and at least here in Texas it’s still the surface of the sun temperature wise. You’ve seen my prior post on dysgraphia and that this was something I’d not yet focused on for our son. Well, he had an Occupational Therapy (OT) evaluation. We found this awesome lady who lives relatively close to me, had worked with my district in the past, and was willing to come to my home. Win! Win!
Now I don’t know anything about OT and sent the evaluation to both our pediatrician and some friends to review. They’re feedback? That it was spot on.
Your son presented as a sweet, cooperative and lovely child. Neurodevelopmental testing was completed with some resistance observed during more difficult tasks requiring static and dynamic balance skills. Core strength was decreased in both the supine flexion and the prone extension positions with compensation demonstrated in the supine flexion position. PrN (vestibular testing) scores yielded above normal which indicates vestibular dysfunction. He shared that he felt nauseous after the testing in the CCW direction so testing in the CW direction was not completed. Reflex testing yielded that two of the primitive reflexes are not integrated (typical integration by one year of age). Both the ATNR (asymmetrical tonic neck reflex) and STNR (symmetrical tonic neck reflex) will affect school performance in reading, writing, copying from the board, sitting erect in the chair without shifting in positioning and speed of executing handwriting tasks. Poor ocular motor skills were also observed of tracking, convergence and divergence, especially in the ability for both eyes to team together with the right eye more decreased than the left. Difficulty in tracking, convergence and divergence are associated with the retained primitive reflexes also contributing to difficulties in school performance table top skills. Balance skills were decreased when standing balance was tested with his eyes open and he was observed to have difficulty in the tandem walking forward. Based on the clinical findings and observations, he presents with difficulties in the sub-cortical upper brainstem area (development from 4-5 months to 4 years of age) which is responsible for our ability to sustain a self regulated state, integration of the primitive reflexes and foundational developmental skills (gross motor, fine motor, ocular motor and oral motor). An inability to sustain a self regulated state will directly affect behavioral responses and an emotional state in order to maintain an optimal arousal level appropriate to environmental demands.
According to his chronological age, neurodevelopment should have been completed through the midbrain sub-cortical area (development from 5 years to 8 years of age). The midbrain’s role is sensory discrimination, sensory processing speed, automaticity of skills and multi-tasking abilities. Per parent report and clinical observations, he is demonstrating difficulty in multi-tasking, attending and focusing and processing auditory information. The midbrain functions are affected due to the breakdown at the upper brain stem sub-cortical level.
The cerebellum controls all motor/muscle function at the sub-cortical level and is positioned between the upper brain stem and midbrain. The portion that is positioned around the upper brain stem controls large gross motor functions and the portion that is positioned around the midbrain controls more precise, small motor functions. Neurodevelopmental testing of the large muscle groups required for core, static and dynamic balance yielded decreased functions. Ocular motor skills requiring use of the small muscles of the eyes and finger precision required for handwriting also yielded decreased functions.
These sub-cortical structures are responsible for 80% of all sensory processing of information through the sensory systems. These systems are responsible for how we interpret and process information for new learning, skill acquisition and refinement of skill to occur.
See? Not ADHD.
If you’re confused by a lot of the content, I’m there with you. I’m still learning all of this myself, but I like it, and it makes sense.
I’ve sent this report to the school. We’ll see in a month what they say about it when we have our first ARD of the year.
Again, ADHD has a very high co-morbidity rate with dyslexia and is a very real medical condition. In my particular case, I have been passionate that ADHD was not the right diagnosis for my son. I trusted my gut and am getting answers.
So our dysgraphia journey continues, hopefully free of the ADHD pressure from our school (which I will NEVER give in to), and the future is looking bright.