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-> Parenting our children
-> Our Challenging Children (gifted, ADHD, sensitive, defiant)
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amother
OP
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 Fri, Apr 16 2021, 3:53 pm
| amother [ Burgundy ] wrote: | | This sounds about right, my child is the same way. Speech therapists help them with theory of mind and how to put their thoughts out there in a more organized way. The time issue probably hasto do with slow processing speed, I would get that checked out so your child can have more time in tests if needed. |
Your child has aspergers or social pragmatic communication disorder?
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amother
Burgundy
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Fri, Apr 16 2021, 4:11 pm
| amother [ OP ] wrote: | | Your child has aspergers or social pragmatic communication disorder? |
Social pragmatic communication disorder. The psychologist said Aspergers is not part of the DSM anymore and that now most children that would have been classified as having Aspergers are diagnosed with Social Pragmatic Communication Disorder.
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amother
OP
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Fri, Apr 16 2021, 4:12 pm
| amother [ Denim ] wrote: | So actually, the time management issue is an executive functioning skill. ADHD, by definition, is an executive functioning disorder. It is not usually due to a slow processing speed.
The problems following directions may be attention related, comprehension related, or working memory related (working memory is a component of your IQ, an executive planning skill, and heavily dependent on good internal focusing skills. It involves keeping information in your brain and manipulating it without losing it. It is essential for all learning, following a conversation, carrying out instructions, etc.)
Aside from getting an actual diagnosis of autism so you can maximize insurance benefits, I would recommend an excellent speech and language evaluation to get an exact picture of strengths and weaknesses.
A speech language pathologist could address all the social concerns as well as executive planning difficulties and other language disorders.
Please go to someone very skilled so you don’t waste time. |
So as far as following directions goes, I'm not sure if I'm explaining it right, but its always like I'm not specific enough. Like I said the mayonnaise is on the top shelf, but its really on the second shelf, but it wouldn't occur to him to look on the second shelf.
I cannot send him into a store to get something. It would be too draining to explain exactly what I need, and answer any follow up questions, and he will anyways come out with the wrong thing. If I give him a chore to do in the house, I will need to repeat it over and over until he gets it right.
He doesn't seem to have any memory issues. He is very, very smart. He can pinpoint anyone's weak spot and expose it. You will never win an argument with him. Everything is a gemara to him. Yet, he routinely fails his courses because he doesn't care about certain subjects.
In terms of time management, he was always missing the ride to school. He will come 20 minutes late to class because he continued playing basketball way after the break ended.
I will ask him to watch the baby for 15 minutes, and after 5, he will think it was 15 minutes.
I'm nervouse to open up the conversation to him about going to a therapist because then he will think I think he is damaged or "crazy,."
When he was 13 he read a story in People Speak by Chaim Walder, in which the protagonist was having issues passing his drivering test and all sorts of other issues. The driving instructor recommended he take pills for ADHD, and suddenly he was able to function like a normal person. When my son read that story, he approached me and told me he thinks he has ADHD, based on the description in the book.
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amother
OP
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Fri, Apr 16 2021, 4:14 pm
| amother [ Burgundy ] wrote: | | Social pragmatic communication disorder. The psychologist said Aspergers is not part of the DSM anymore and that now most children that would have been classified as having Aspergers are diagnosed with Social Pragmatic Communication Disorder. |
Thats exactly what they told me!
So when you need to describe his issue to someone, do you say he has "SPCD"? They have no clue what it is...
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amother
Denim
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Fri, Apr 16 2021, 4:17 pm
| amother [ Burgundy ] wrote: | | Not always. Sometimes it's slow processing speed and it gets misdiagnosed as ADHD. That's why it's important to get a very thorough evaluation. |
Sometimes. I agree. Sometimes slow processing speed can hamper executive functioning skills (time management just being one of them). However, having evaluated over a thousand children, many with ADHD, I can tell you that most of the time it’s the other way around. ADHD easily gets misdiagnosed as a slow processing speed, especially ADHD that is not easily recognizable (ie there is no evident impulsivity, hyperactivity, visible inattention, etc).
That is why, as you said, an excellent evaluation is crucial.
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amother
Burgundy
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Fri, Apr 16 2021, 4:20 pm
| amother [ OP ] wrote: | Thats exactly what they told me!
So when you need to describe his issue to someone, do you say he has "SPCD"? They have no clue what it is... | Usually I only explain if it's necessary, like to a teacher or school, and I say he has difficulties with social situations and social clues, and that leads to misunderstandings often. Mine is also very smart, very high IQ overall, ADHD was ruled out in standardized testing, but has slow processing speed so he takes longer in tests and conversations are not in real time for him so that's why it's something to check out if he has time management issues.
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amother
Denim
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Fri, Apr 16 2021, 4:24 pm
| amother [ OP ] wrote: | So as far as following directions goes, I'm not sure if I'm explaining it right, but its always like I'm not specific enough. Like I said the mayonnaise is on the top shelf, but its really on the second shelf, but it wouldn't occur to him to look on the second shelf.
I cannot send him into a store to get something. It would be too draining to explain exactly what I need, and answer any follow up questions, and he will anyways come out with the wrong thing. If I give him a chore to do in the house, I will need to repeat it over and over until he gets it right.
He doesn't seem to have any memory issues. He is very, very smart. He can pinpoint anyone's weak spot and expose it. You will never win an argument with him. Everything is a gemara to him. Yet, he routinely fails his courses because he doesn't care about certain subjects.
In terms of time management, he was always missing the ride to school. He will come 20 minutes late to class because he continued playing basketball way after the break ended.
I will ask him to watch the baby for 15 minutes, and after 5, he will think it was 15 minutes.
I'm nervouse to open up the conversation to him about going to a therapist because then he will think I think he is damaged or "crazy,."
When he was 13 he read a story in People Speak by Chaim Walder, in which the protagonist was having issues passing his drivering test and all sorts of other issues. The driving instructor recommended he take pills for ADHD, and suddenly he was able to function like a normal person. When my son read that story, he approached me and told me he thinks he has ADHD, based on the description in the book. |
It sounds like he misses subtle implied messages. These are messages that are supposed to be self understood and involve a lot of reasoning.
If, for example, you asked him to get something on a different shelf and he cousins find it, the implied message would be to look an another shelf. You shouldn’t have to spell it out.
This is a typical pragmatic language issue.
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amother
Denim
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Fri, Apr 16 2021, 4:27 pm
| amother [ OP ] wrote: | So as far as following directions goes, I'm not sure if I'm explaining it right, but its always like I'm not specific enough. Like I said the mayonnaise is on the top shelf, but its really on the second shelf, but it wouldn't occur to him to look on the second shelf.
I cannot send him into a store to get something. It would be too draining to explain exactly what I need, and answer any follow up questions, and he will anyways come out with the wrong thing. If I give him a chore to do in the house, I will need to repeat it over and over until he gets it right.
He doesn't seem to have any memory issues. He is very, very smart. He can pinpoint anyone's weak spot and expose it. You will never win an argument with him. Everything is a gemara to him. Yet, he routinely fails his courses because he doesn't care about certain subjects.
In terms of time management, he was always missing the ride to school. He will come 20 minutes late to class because he continued playing basketball way after the break ended.
I will ask him to watch the baby for 15 minutes, and after 5, he will think it was 15 minutes.
I'm nervouse to open up the conversation to him about going to a therapist because then he will think I think he is damaged or "crazy,."
When he was 13 he read a story in People Speak by Chaim Walder, in which the protagonist was having issues passing his drivering test and all sorts of other issues. The driving instructor recommended he take pills for ADHD, and suddenly he was able to function like a normal person. When my son read that story, he approached me and told me he thinks he has ADHD, based on the description in the book. |
The time management description you just gave is an executive functioning weakness. It has nothing to do with slow processing speed.
Working memory doesn’t at all have anything to do with regular memory. It’s not losing information as your work with it, nothing to do with short or long term memory.
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amother
OP
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Fri, Apr 16 2021, 5:05 pm
| amother [ Denim ] wrote: | Sometimes. I agree. Sometimes slow processing speed can hamper executive functioning skills (time management just being one of them). However, having evaluated over a thousand children, many with ADHD, I can tell you that most of the time it’s the other way around. ADHD easily gets misdiagnosed as a slow processing speed, especially ADHD that is not easily recognizable (ie there is no evident impulsivity, hyperactivity, visible inattention, etc).
That is why, as you said, an excellent evaluation is crucial. |
Do you do evaluations on Zoom?
I spent about 2500 on an evaluation for him a few years ago. I got a 25 page report...I am kind of unsure if I need another one. 
In the end of the day, is the exact evaluation the important piece, or is it enough to just work on the skills he is lacking in.
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amother
OP
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Fri, Apr 16 2021, 5:09 pm
And btw, I took him for a few sessions to a huge, very choshuv child psychologist, when he was about 12. The type that charges like 500 a session.
He basically diagnosed him as having Aspergers within 10 minutes, like it was the most obvious thing. (It was a strange experience for me, because my son was acting so weird in his office. He was very nervous I guess, and started doing these stimming things that he never did before. Thats what the doctor saw)
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amother
Burgundy
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Fri, Apr 16 2021, 5:11 pm
| amother [ OP ] wrote: | Do you do evaluations on Zoom?
I spent about 2500 on an evaluation for him a few years ago. I got a 25 page report...I am kind of unsure if I need another one.
In the end of the day, is the exact evaluation the important piece, or is it enough to just work on the skills he is lacking in. | You can't get a Psych evaluation on Zoom and anyone that tells you otherwise don't know what they are talking about. If you can't afford right now, certain places like NYU, Columbia and CUNY have sliding fees and do a very comprehensive evaluation. You might have to wait a few months for a spot but it's worth it.
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amother
OP
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Fri, Apr 16 2021, 5:16 pm
| amother [ Burgundy ] wrote: | | You can't get a Psych evaluation on Zoom and anyone that tells you otherwise don't know what they are talking about. If you can't afford right now, certain places like NYU, Columbia and CUNY have sliding fees and do a very comprehensive evaluation. You might have to wait a few months for a spot but it's worth it. |
I don't live in the tri-State area.
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amother
Denim
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Fri, Apr 16 2021, 5:16 pm
I wouldn’t recommend an evaluation on zoom.
I don’t do that.
I think Relief could probably help you get someone in your area. You could also make an appointment with Dr. Mandelman in NY who’d possibly do a conference with you over zoom. He could review all the reports and guide you. He’s excellent and if you give him all your reports plus make sure to report what you’ve written here, he may be able to guide you to find someone locally and/or someone who could treat over zoom.
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amother
OP
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Fri, Apr 16 2021, 5:21 pm
| amother [ Denim ] wrote: | I wouldn’t recommend an evaluation on zoom.
I don’t do that.
I think Relief could probably help you get someone in your area. You could also make an appointment with Dr. Mandelman in NY who’d possibly do a conference with you over zoom. He could review all the reports and guide you. He’s excellent and if you give him all your reports plus make sure to report what you’ve written here, he may be able to guide you to find someone locally and/or someone who could treat over zoom. |
Dr. Shmuel Mandelman?
Is Relief a referral service?
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amother
Denim
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Fri, Apr 16 2021, 6:05 pm
| amother [ OP ] wrote: | Dr. Shmuel Mandelman?
Is Relief a referral service? |
Yes and yes
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FranticFrummie
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Sat, Apr 17 2021, 1:58 pm
DD is not on the spectrum, but she does have an alphabet soup of other things. Nonverbal Learning Delay, PPD-NOS, ADHD, executive functioning, and rigid thinking.
She had a few years of SLP in elementary school, and it worked wonders for her. She had it individually, and in group where similar girls could practice their social skills on each other.
When she was little I knew something was off, but it took me a long time to get people to believe me. If I said "OK, time for socks and shoes!" nothing would get done. I had to break it down for her.
"Go get your socks."
"Put your socks on."
"Go get your shoes."
"Put your shoes on."
I had to allow time for each instruction to sink in, and sometimes she'd get distracted and forget what she was supposed to do. I practically had to hold her hand the whole way.
She had a hard time understanding figures of speech. I'll never forget one time we were at friends' for Shabbos, and I was really tired. DD said "Mama, what are you doing?" and I said "Nothing, just staring off into space." She peered hard into the direction I'd been looking, and said with concern "Mama, there's nothing out there!"
Thanks to the help that she's gotten, and that she went to a high school that also supported her IEP, she's doing infinitely better now.
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amother
Smokey
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Sat, Apr 17 2021, 2:01 pm
This is ASD 100%.
And this is not considered high functioning. High functioning people learn social skills, eye contact, and can integrate into society very well.
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amother
Amethyst
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Sat, Apr 17 2021, 2:09 pm
| amother [ Smokey ] wrote: | This is ASD 100%.
And this is not considered high functioning. High functioning people learn social skills, eye contact, and can integrate into society very well. |
100% agreed. Classic ASD.
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amother
OP
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Sun, Apr 18 2021, 2:01 pm
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Thank you all, especially denim, for your guidance. You should be blessed.
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amother
Magenta
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Sun, Apr 18 2021, 2:08 pm
| amother [ OP ] wrote: | Do you do evaluations on Zoom?
I spent about 2500 on an evaluation for him a few years ago. I got a 25 page report...I am kind of unsure if I need another one.
In the end of the day, is the exact evaluation the important piece, or is it enough to just work on the skills he is lacking in. |
You don't need another one if you pursue therapy with the basis that he has both ASD & SCD. You already know he has both. So tell the therapists that that is what he needs help with.
If an official diagnosis is needed in order for insurance to cover the therapy, then you can spend the money at that point.
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