"Does your DS have learning difficulties" ADD? ADHD? A storm in a tea-cup?

[leaningtoweroflego]

DS is bright but can be very oppositional, distractable and strong willed.

It is just his personality or something more? I've wondered on and off for a while, but I'm considering it again this week as he went for an ear test. I couldn't go in with him as they didn't want toddler DD there. Apparently DS was very obviously faking that he couldn't hear any of the sounds. The medical professional (a nurse maybe?) who did the test asked me if he had any learning difficulties. I said I'd wondered about ADD before but he's bright and I'd spoken to the school and they weren't concerned.

She did some more tests - and on tests where he had to repeat words he heard, he changed the beginning of each word to make it a nonsense word, to pretend he couldn't hear it properly. The (?)nurse and then the consultant said some cryptic stuff about how the way he behaved was in line with certain "personality types" but they obviously didn't want to say too much in front of him.

Does anyone know what they were getting at? (I think I may call the hospital to ask.)

Some more info, in case it's relevant ... we have ASD in the family, and I suspect mild ADD in myself and my father also, and possibly DS. Enough for me to bring it up with his teacher anyway.

With the ear tests yesterday I told him I knew he was pretending and he got really upset, dug his heels in and protested his innocence. He also pretended (or perhaps exaggerated) he had a hurt wrist a couple of weeks ago. It's obvious as he's a terrible actor and forgets it's meant to hurt IYSWIM!

Also, I do sometimes wonder if there's anything up with DS as he gets distracted so easily. He finds it hard to remember instructions, he forgets what he's meant to be doing. He also gets very focussed on stuff and doesn't respond till he's shouted at. In fact he doesn't really do anything unless we shout, which is upsetting for him and not ideal parenting. And he argues with EVERYTHING! That all sounds like a normal child I know! But it is to an extreme, it's just different with him.

He can get very fixed on ideas - like when he went to a friend's house, they didn't have the toy he'd played with the time before - we'd spoken about it on the way over, and he was looking forward to it - but when it wasn;t there he then refused to join in at all, and was really upset, I think because he found it hard that things weren't as he expected. He finds it very hard to back down if others have different views or ideas to him. He can get upset very easily. His old teacher described him as "emotionally immature", not in a way that we should be concerned, but more of a "don't worry, he'll grow up". But I wonder if there's more to it.

He's 7 and a very bright boy - for example he's in a small group in his class who are being extended for reading, for example, and he's good at maths too. He has a lovely nature too.

Is it worth pushing this kind of thing? If he does have ADD, or is on the Autistic spectrum, I imagine it's pretty mild.

I think I would like to know so I can understand and help him better. I do get very frustrated with him sometimes, I imagine if I understood how his brain works better it might make family life easier for us all, especially him.

Or perhaps it's just that he is a person with an oppositional nature and I'm looking for a reason that just isn't there?!

How would I go about investigating this further?

If anyone has read all of that, thank you very much!

My initial reaction is that you may well be totally misjudging him.

What if he genuinely couldn't hear the beginnings by of the words?
What if he is guessing, not hearing correctly?
What if his brain is struggling to process what he hears?

Why would he want to "fake" a hearing test?

What if his body language isn't expressing his real feelings, but is camouflage?
What if he is working hard to use his intelligence to try to "blend in"?

Don't guess, but do get him referred to a paediatrician. Keep a diary of things you observe.

I promise I'm not misjudging him.

It was totally obvious to the medical professional that he was faking it, to the point that she asked me if he had learning difficulties.

The point of the test with the words was simply to see if he could hear the sound, not understand the words IYSWIM. He thought he was being tested on whether he could understand the words, and tried to fail that.

This was after the first test where he consistently pretended he couldn't hear sounds that were plenty loud enough to hear.

The nurse also did tests on his ear health (usually done on babies who can't self-report) and his ear health was fine.

"Why would he want to "fake" a hearing test?"

I have no idea, but he did. I would also like to know why.

My DS faked a hearing test last week (pretended to be asleep!!) he's also been accused of messing around when I know he wasn't but actually couldn't hear.

Go back to audio with a babysitter for your littlest and sit in on the test. It's the only way you'll know. I would make sure you have a decent set of test results before you go to paeds.

I haven't got experience with ADD so can't comment on that really, but kids being daft in hearing tests is definitely not an unknown!

He certainly could have ASD. Lots of flags in what you described.

You can choose to try and get a dx or not. A dx doesn't bring anything with it but I think it'll put your mind at rest.

This made me think of PDA.
Ds would fake tests as a demand avoidance strategy. One of his diagnostic tests he came out as below average IQ due to avoidance, luckily the psychologist recognised this.
He needed two eye tests as his first came back as very short sighted, which I know he isn't.

IMO the thing to do is research as much as you can about add, ADHD, HFA, PDA, those sort of spectrum conditions and work out yourself if your ds fits any. He may not, and it may be a case of different parenting strategies.
IME if the child has SN but isn't presenting obviously, it can be difficult to be taken seriously, so you need to have a fair idea of what's going on and where you want this to go (referral, eventual diagnosis).
It might be worth trying to follow a parenting technique (eg 123 magic), give it a good go and keep a diary.

From what you have written, I would be reading up about PDA and demand avoidance in general.

(Disclaimer: the following anecdote does not mean I think your ds has ASD)

My dd1 used to always give the wrong answer during testing. So much so, that by the age of 4, she was noted as 'untestable' because the accuracy of her answers cod not be guaranteed. Eg, when asked to name what she saw in the picture (an animal, let's say a dog) she would reply 'it's not a dinosaur'. When asked to point to eg the blue ball, she would point to a red one, and say 'that's not blue'. So she was right in her answers, but untestable due to not answering the question posed. She has ASD, and when younger was particularly demand avoidant. She could not cope with the pressure of being asked anything, couldn't cope with the fear of possibly giving the wrong answer (maybe she'd misheard the question, maybe it was a trick, if she answered this one ok, the questions might get harder, and so on)

I disagree that a diagnosis doesn't bring you anything.
It brings understanding, it can bring more support, not necessarily, but you at least have the opportunity to fight for support which is impossible without a diagnosis.
With a diagnosis you will be able to go on a cygnet course (if it is ASD) which gives you more understanding, and you will meet other parents in the same boat.
It means you know what you are up against and you can become your child's specialist, and start to understand how he works and use appropriate strategies (eg, for us, knowing that ds has PDA means we can use those strategies and feel confident using them, even though others think we are pandering to him)
It's also important for the child themselves, so they can eventually understand themselves and accept themselves.

It sounds like he was attention seeking to me in the hearing test but that's not to say he doesn't have other difficulties going on as well.
The thing with shouting all the time is that he will stop registering you when you speak in a normal voice and then you have to shout even more. Try to go to him and get his attention before speaking to him and cut down on the need to shout.
Do school find him difficult to manage? If so see your GP and ask for a referral to a developmental paediatrician. If they don't asks what strategies they use and try using them at home as well before asking for a referral if you still believe you need one.

My dd tried to fake her eyetest as she wanted glasses so much.

The faking thing wouldn't concern me the little bugger but the refusing to play because his friend didn't have the toy he had last time sounds a little odd.

"if the child has SN but isn't presenting obviously, it can be difficult to be taken seriously, so you need to have a fair idea of what's going on and where you want this to go"

I agree. I've already tried the school. I spoke to his teacher last year, I asked if she had any concerns about his concentration, and said I'd been reading up on ADD. She said she'd had a child with ADHD in her class before and it was so serious he literally couldn't concentrate, and that she had no concerns with my DS in comparison.

One interpretation of that is that because he's bright and achieving well, he's not a concern to the school academically, but that could mean underlying issues could be missed.

Even so, I think it might be worth talking to his teacher this year. She's much more experienced than his teacher last year, and she said at parents evening that she felt there was "more in the tank" but was baffled as how to access it - meaning he's bright but not working to his ability in her opinion.

My son holds it together in school, and any behaviour seen is put down to naughtiness because there are no stereotypical behaviours.
At home he ticks boxes for ADHD, but it was explained to us that anxiety can manifest as ADHD.

Ds sounds similar, he is far brighter than any of his teachers think, but because he's performing averagely, they think he's fine, and because he has a school persona, no-one else can see this potential.

And so many times he was dismissed because there were children far naughtier in the class, so I'd go in to talk about ds, and they'd compare him to another boy rather than focusing on how they could help ds.
If your ds is compared again, you could stop them and say you've requested a meeting for him, not for another child.

"Do school find him difficult to manage"

His teacher last year found him very difficult at first. She shouted at him, which he wasn't used to in a school context, and it took several weeks before he would cooperate with her.

I suspect a different nursery would have found him difficult to manage if it was the kind of place that was concerned with children conforming.

When I went with him on settling in days, he didn't want to join in at all, for example all the other kids would be asked to sit in a circle. I tried to encourage him to join them, as he was running around causing havoc while all the other kids sat in a circle, but the nursery said "don't worry, don't try to make him, he'll do it eventually".

It took him ages before he started to join in tbough. DD is at the same nursery now, we were talking about DS recently. They remember (fondly) that he really didn't want to conform, and it took him a very long time to get it. I suspect in another establishment that would have been a problem.

More recently, he was asked to leave an after school club as he wasn't listening to the instructor.

If you speak with the teacher, it might be as well to write down incidents like this as evidence that not all is well, in case they minimise it.

"Try to go to him and get his attention before speaking to him and cut down on the need to shout."

Yes, of course I do try! I am not proud of shouting, but I am only human!

Yesterday for example. I said to DS - the following in a speaking voice "please put your shoes on". He didn't register that I had spoken to him. I said "DS I am speaking to you" he ignored me. "DS!" (slightly louder, but not shouting) I got his attention. "Please can you put your shoes on". He appeared to move towards the shoes.

I left the room to get my own shoes. Came back into the room, DS was playing.
Me: "DS, why are you not putting your shoes on?"
DS: "I don't know where they are"
Me: "They are here, right in front of you!" I point to shoes, right in front of him. "please put your shoes on".

I leave the room.

I come back, he is still playing.

We are late for school. Now, I shout. "DS - PUT - YOUR - SHOES - ON!!!"
He puts his shoes on, and cries, and I feel bad.

Then, five minutes later, I say "DS please put your coat on". He says "I don't know where it is". I say "It's on the banister" He says "I can't see it" (it is right in front of him, it is the top coat on the banister". I say "DS it is the top coat, it's right in front of you." He says "I don't know where it is". I should "DS - PUT - YOUR - COAT - ON". He puts it on and is very upset with me.

When we leave the house a few minutes later all is forgotten (on the surface at least) and we have nice chats on the walk to school.

I know all this might sound like everyday stuff, but it is repeated with every little thing. I don't shout at everything. I shout because we have already had similar conversations about everything he needs to do to get ready (and I haven't shouted then), and also about just trying to get his attention, and by the time it gets to shoes and coat we are late and I am out of patience. 2.5 year old DD can follow instructions better, mainly because she wants to IMO.

I know shouting is not ideal, and some strategies would help. But I'm also keen to understand why he is like he is, as I suspect that may help with choosing the right strategies.

"If your ds is compared again, you could stop them and say you've requested a meeting for him, not for another child."

Yes, exactly! I'll keep that one up my sleeve, thanks!

"It might be worth trying to follow a parenting technique (eg 123 magic), give it a good go and keep a diary."

We started using some of the techniques from "Calmer Happier Easier Parenting" and they worked well, I think revisiting that would be a good idea.

This is a booklet about pda

It tells you about it. On page 30/31 there is an extreme avoidance questionnaire, it's quite a good place to start.
The situation you describe about putting shoes on is so like ds it made me laugh.

Sorry, I feel like I've jumped on this, feel free to ignore!

PandasRock that's interesting.

"She could not cope with the pressure of being asked anything, couldn't cope with the fear of possibly giving the wrong answer"

I suspect a fair bit of DS's personality comes from me, we are similar in lots of ways.

Reading up on ADD for DS has been a revelation to me, I am now fairly convinced I have ADD myself - it brings together lots of different bits of my personality under one heading (forgetfulness, procrastination, disorganisation, etc ). I read somewhere (no idea how true it is!) that procrastination can be because of a fear of failure, of being "judged" if you finish the task. I don't feel like I'm "afraid" of finishing or being judged - would I actually be aware of the fear? Would DS?

(My own experiences possibly a red herring here! But it just rang a bell)

"Sorry, I feel like I've jumped on this, feel free to ignore!"

Not at all, I really appreciate your advice, thanks!

Just reading through the booklet on PDA.

A lot of it rang a bell:

"children often behave as mini adults and often do not seem to recognise their status as junior members of the household"

This one is interesting - his teacher last year said she thought he saw himself as an adult.

"children with PDA show good imaginative play ... At times this imagination can be so strong that the boundaries between reality and fantasy can become blurred."

YY to this. DS has a very active imagination - when he was younger we praised him all the time for his amazing imagination. But these days I sometimes wonder if he actually knows what reality is, he can get so invested in his made up scenarios. Sometimes these relate to perceived ill-treatment by others - so a child will bump into him up by accident and knock him over, and he will report that they did it deliberately as he saw them laughing about it slyly as they did it. The laughing bit is made up, but he really seems to believe it.

Also stuff like this ...

"From an early age parents are aware that their child is different and challenging. However, they may well be bright and promising"

"Children with PDA are determined, stubborn and strong willed, but can also be charming, imaginative and entertaining. Many can show good levels of empathy, social awareness and understanding"

"Bossiness and a need to be in charge"

" Behaviours can appear to be at the extreme end of ‘the terrible twos’ and parents may not be unduly concerned until it is apparent that this is not merely a passing phase that they will grow out of."

"Getting a child to comply with the most basic day to day requirements of life is a challenge and the same battles are fought every day."

"Typically the child will expend much more time and energy evading and resisting a demand than they would use complying in the first place."

The PDA document doesn't describe DS 100% but there's an awful lot of bells ringing.

Given we have ASD in the family it wouldn't be too surprising if DS is on the spectrum.

This is concerning, and a compelling reason for getting a diagnosis sooner than later I imagine:

"Some children continue to mask their difficulties in school ...
for most, as demands of school increase more difficulties spill out in educational settings. Very often, once this does start, the rate of decline can catch everyone by surprise. Multiple exclusions are common. Frequently, schools are no longer able to cope and managed transfers to alternative provisions are made."