New Territory: Results from Neuropsychological Evaluation

"I am so bored with this."

Last week we received a written report on Luke and Isabelle’s neuropsychological evaluations. Today we talked to our doctor about the results and discussed ways we can help the kids. I have learned a lot in the last week about ADHD and related issues that we haven’t delved into until now.

Luke’s clinical diagnosis in a nutshell: He has ADHD-combined type (both hyperactive and inattentive), generalized anxiety, and disruptive behavior disorder-not otherwise specified (DBD-NOS). The DBD-NOS is a term for behavioral symptoms that do not warrant a diagnosis of oppositional defiant disorder but reflect difficulties in controlling aggressive and non-compliant behaviors. On a positive note, his intellectual capacity falls into the superior range and his social behavior among peers shows understanding of social cues.

Izzy’s clinical diagnosis in a nutshell: She has ADHD-combined type (both hyperactive and inattentive), mood disorder-not otherwise specified, and pervasive developmental disorder-not otherwise specified. The mood disorder-not otherwise specified essentially means that she has some level of anxiety and depression but not enough to be diagnosed as generalized anxiety or depression. The pervasive developmental disorder-not otherwise specified means that she has symptoms approaching Asperger’s (which is on the Autism Spectrum) but does not cross the threshold. On a positive note, Izzy shows superior intellect in several areas and a “splinter” intelligence in creative cognition. This means that she is exceptional—off the charts, I guess—in creative intellect. Apparently, these splinter intelligences are great gifts but cause difficulties because the person gets frustrated with areas of weakness.

So now, along with learning about ADHD, I need to learn more about anxiety, DBD, and PDD. One thing I learned this week that I didn’t know before is that ADHD is not on the Autism Spectrum. Symptoms overlap, but ADHD is not part of the spectrum. Here is a good explanation I found online:

Understanding ADHD and Autism Spectrum Disorders

This is from Martin L. Kutscher, MD  http://www.pediatricneurology.com/autism.htm#ADHD

It is probably best to consider ADHD as sometimes sharing the following symptoms with—but not part of—the Autistic Disorders Spectrum: 

·         Poor reading of social clues (“Johnny, you’re such a social klutz. Can’t you see that the other children think that’s weird.”)

·         Poor ability to utilize “self-talk” to work through a problem (“Johnny, what were you thinking?! Did you ever think this through?”)

·         Poor sense of self awareness (Johnny’s true answer to the above question is probably “I don’t have a clue.  I guess I wasn’t actually thinking.”)

·        Do better with predictable routine.

·         Poor generalization of rules (“Johnny, I told you to shake hands with your teachers. Why didn’t you shake hands with the principal?)

Here are the assessments included in their evaluation:

Conner’s Comprehensive Behavior Rating Scale Parent and Teacher Form

Autism Spectrum Rating Scales Parent and Teacher Form

Home Situations Questionnaire

Elementary School Situations Questionnaire

Review of records

Social Attributes Checklist

Teacher Observation Checklist

Cognitive Assessment System

Purdue Pegboard

Autism Diagnostic Observation

PDD Screening Questionnaire

Letter/Number Writing Sample

Wechsler Intelligence Scale for Children IV

Conners’ Continuous Performance Test II

Woodcock Johnson III Tests of Academic Achievement

Peabody Picture Vocabulary Test IV

Expressive Vocabulary Test II

Developmental Test of Visual Motor Integration

Revised Children’s Manifest Anxiety Scale

Reynold’s Children’s Depression Scale

Clinical Interview

And how do I feel about all this? I’ll get into that next time. Baby’s awake.