Wellll.... isn't this interesting??? It looks like Dominic may NOT have ADHD after all! The pyschologist did IQ and achievement testing and our little pickle is smart! His overall IQ tested at 124 and his achievement functioning tested at 132.
Here's the really interesting part about the ADHD. On the IQ test, three subtests indicate excellent performance with attention (working memory), concentration (cognitive efficiency), and delayed recall (scoring 132, 126, and 138 respectively). Because of these scores, it is highly unlikely Dominic has ADHD!
There are three types of ADHD:
3. Combined Type
Previously, Dominic was diagnosed as Type 3, Combined Type ADHD. Now Types 1 and 3 can be ruled out. There may still be a possibility that he is Type 2, but the doc recommends making some environmental changes first to see if the hyper and impulsive behaviors stem from being under-challenged. If the changes do not make a difference with these behaviors, then we'll feel more confident that Dominic has an organic problem with impulsivity and hyperactivity. He's testing at the 2nd grade level for reading and math. Writing in on grade level (kinder) and is a source of great frustration to him. Little did I know that he has fine motor delays as well as trouble with some oral language; and the doc tenatively diagnosed him with Developmental Coordination Disorder and Phonological Disorder. She recommends occupational therapy and a home-based writing program to help him with the writing delays ("his impairments in fine motor cause him to find seated and written work laborious and almost unbearable"). He could also benefit from some speech therapy to help with some pronunciation issues he's having (though I think this is a mild issue since he is completely understandable). Emotionally, Dominic does have some trouble with social skills and being oppositional. She recommended a social skills group and environmental changes. Again, if these changes don't make a difference in his behavior, then we might be dealing with something more substantial like Oppositional Defiant Disorder (I hope not).
So we have a long list of recommendations:
1. Private occupational therapy for fine motor delays and a sensory dysfunction evaluation.
2. Speech therapy evalation for phonological processing problems.
3. Challenging academic material, gifted and talented program.
4. 504 plan for fine motor coordination and behavioral challenges.
5. Modifications to curriculum for fine motor issues (use a pencil grip, assessments not based on writing, etc.).
6. School-based social skills group.
7. Home-based instruction writing program.
8. Individual and family counseling.
Now I need to set up private evaluations for OT and ST. I need to talk with his teacher, principal, and school counselor to create a 504 plan and see what options we have academically. Our school does not offer a TAG (talented and gifted) program for kindergarten... it starts in first grade. I'm not sure how we will be able to challenge him now. If we can't find something to interest him, he will be so bored that his behavior problems will intensify. He's only had 1 good day at school so far.
Egad, am I glad I listened to Curtis about not continuing the ADHD medication! No wonder Dominic hated it. When he said, "Mommy, it makes me slow," he really meant it. I am so glad we went ahead with the psychological testing! I am feeling relieved that Dominic may not have ADHD (for his sake... I think having a brain that can't stop you before you start would be quite frustrating!) but I also realize that his issues will continue to be challenging for him. Sometimes it's easy to forget that he's just a 5-year old boy!