Wednesday, February 20, 2013

"As parents, our task is ..."

"As parents, our task is to discover who our child is 
and help the child find his own profession."
pg. 81, Misdiagnosis and Dual Diagnosis of Gifted Children and Adults, 
James T. Webb, et al

Admitting your child might be different, be it learning disabled or gifted, is difficult.  With programs like "No Child Left Behind," however, it has become much more acceptable to have a learning disabled child, and those who are intellectually or creatively gifted are seen as "weird" or "freaks."  Oftentimes parents are blamed for making their children the way they are by allowing them access to knowledge and learning at a young age.  A parent can no more make their child gifted by beginning to teach them at an early age than another parent can make their child disabled by not teaching them young.  In fact, it may be hard to believe, but most parents do not wish any differences upon their children at all, because our society sees differences of any kind (other than talent in sports) as a disadvantage.  There may be pressure, on both the child and the parents, to make the child conform to what society sees as "normal," be it through discipline, therapy or medication.  Webb, et al. states that "the attempt to give gifted children a 'normal' life and a 'normal' upbringing is like trying to make a giraffe act more like a horse -- an experience that is painful for all involved" (pg. 64).  Yet it is these differences, an integral part of who your child is, that may make up some of the more unique aspects of his or her personality.  If your child is not different in the same way that mine is, no offense is meant if/when I make generalizations or comments about groups of children.  If you have a child who is different from "normal," however he or she may be different, know that there are others out there who understand.  I hope my speaking out about the struggles we have parenting SC gives you confidence to do the same.

After one horrific piano lesson in early December 2012, I called SC's pediatrician in tears and made an appointment for an "11:30 consultation."  SC had just spent the entire lesson rolling around on the floor under the piano, jumping unrhythmically on purpose off the beats, answering questions about letters incorrectly (also on purpose), and just generally refusing to follow any of the teacher's instructions.  It may seem that she was just acting like a typical four-year-old, but the problem was she was capable of playing the piece the teacher had asked her to play.  In fact, when she finally played it (for the first time ever, after seeing the teacher play it only once, at the end of the lesson), she played it perfectly, with no mistakes.  

See, we had just moved her to private lessons, at the request of her former teacher, due to her impatience at waiting for the other children in her group lesson to catch up.  She caught on to everything her teacher had been doing so quickly, she was bored while the other kids tried to learn, and her previous teacher thought it might be a good idea if the entire lesson was focused on her.  In fact, this was a pattern that was becoming all too apparent, with piano lessons being the latest request to move SC from group lessons to private, because she understood things very quickly, and then would become bored (and inattentive, disobedient, destructive, out-of-control) while she waited for the other kids to "catch up" to where she was.

So, we made this appointment with her pediatrician, and he asked a series of questions.  We tried to give our observations, but it is hard to fit four and a half years of life with SC into a thirty minute consultation.  He said she sounded bright, but he also said he thought she had ADHD.  He then gave us  a checklist to fill out and one for each of her teachers, as well as a pamphlet about ADHD, and he said that the AAP recommends both occupational therapy/intervention plans as well as medication, and that doing both showed the best results with many patients.  

After making a follow-up for one month hence, we left the appointment dumbstruck.  ADHD was something that we had heard about, but we were not expecting him to say was SC's problem.  In fact, what we were hoping was that he would say she is not that different from all other kids her age, and maybe she is just more easily bored than others, and here is the solution to this problem.  In fact, I know I was looking for a magic answer.  A book of twelve steps to follow or a list of if...then statements that we matched up to her behaviors that made her more manageable   Instead, we left with the idea that our child might need to be medicated for the rest of her life in order to "fit in" to the acceptable social norms.  Now, I am not against all medication, and I believe that there are truly children that need to be on medication for their differences, but I also believe that parents should not swap one set of problems (the ADHD-like symptoms) for another set of problems (the side effects) that just so happen to be socially acceptable just because things are hard.  So, I did what I always do when I am faced with a problem - I started reading.

In August, I listed some books that I wanted to read as we attempt to decide which path would be the best educational path for SC, some of them about gifted children because it had been mentioned to us that SC seems to do things developmentally quicker than other children.  I thought it would be a good idea to include them, to see if they had any hints that might make our decision easier.  While  I have read some of these books in part, life tends to get in the way of our plans, and I have yet to completely finish any but the first two on the list, which are really long essays rather than books.  

However, as I attempted these past weeks to get back on track to learning about SC, I found a book called Misdiagnosis and Dual Diagnoses of Gifted Children and Adults by the author of of one of the gifted books already on my list.  This caught my eye because I had just spent over an hour with SC's preschool teacher, discussing her behavior in class, and that her teacher feels she does not have ADHD (she has been trained to recognize it, as well as gifted students through her teaching degree program and years in the public school system) but that she is even more highly advanced/gifted than we all initially thought.  She said that she believes the behavior problems are a combination of boredom and SC's emotional development still being at four years old, right where her peers are.

The authors of Misdiagnosis suggest that "as many as half of gifted children with the diagnosis of ADD/ADHD do not have the significant impairments due to attention or hyperactivity that are required ... to make an ADD/ADHD diagnosis" (pg. 37).  The problem is that many of the characteristics of children with ADHD actually can also be seen in gifted children, but the difference in the symptoms is only evident when someone asks the question "why" - why are they behaving the way they are.  For example, both a child with ADHD and a gifted child may not follow directions well, but a child with ADHD actually has trouble following them (and all rules/directions), while a gifted child is choosing not to follow certain ones after questioning their legitimacy.  Both children with ADHD and gifted children may seem unable to concentrate on tasks, but a child with ADHD has trouble focusing on all tasks that do not have immediate consequences, while a gifted child chooses not to focus on tasks they deem irrelevant or uninteresting.  It is very important to ask why a child is doing (or not doing) they thing that is causing the problem.  With SC, we already knew that the why of the behaviors was a convoluted explanation and a conscious choice on her part.  However, Misdiagnosis (and the resources I found at SENG) has opened up the possibility that this is because she is gifted rather than something needs to be "fixed."  Apparently, this is normal (for her).  

One of the solutions that the book offers to behavior problems is that "changing the environment can effectively treat many conditions" (pg. xxxiii).  The theory is that "many of these disorders [as diagnosed in gifted children] are the result of the interaction between temperament and environment" (pg. xxxiii), which is very much what SC's preschool teacher suggested.  In the preschool classroom, she has started pulling SC out for higher level work, like beginning addition, more advanced reading/phonics work.  She suggested that when we are working on homeschooling, that instead of seeing SC's desire to turn her handwriting letters into aliens or bugs as not following directions, to view them as her being creative because she is bored.  So, we cut down the handwriting to a more manageable "if you do this one line well, you can skip the next two," and it has really worked.  I get a focused, well written line of letters and she moves through it without feeling overwhelmed and bored.  We got a timer that we set for twenty minutes (that she loves to set and look at) before we start each new activity, and that has motivated her to work quickly.  If she isn't done by that time, we move on to something else and either come back to the first activity or, if her work so far was exceptional and it was clear she was bored, we don't.  We replaced her chair with an exercise ball that has kept her from bouncing all over the place (pun intended) as she tried to work on activities that require writing, be it phonics, math or handwriting.  

We have also headed in a more "unschooling" direction that is SC focused and led by her interests because, at the moment, we can do that.  She is still only four and a half years old, and she deserves play time.  I completely cut out science and French (other than videos or iPad games) and we will just wait until next year, and I am okay with that.  We took a trip to see mummies even though it cut out half of a week.  Some days we only do math, and some days we do everything.  Some days she wants to do art four times and that is okay, because then when we do get to things like phonics or handwriting, she is more interested in it and it does not feel like I am forcing her into it.

Misdiagnosis has opened up my eyes to the idea that SC is in the profoundly gifted category of children, and while that is nice to hear, it is also quite scary.  I like to joke that she is smarter than both AC and I, but it looks like it is true.  So the question becomes, what now?  Well, we went back to our pediatrician, armed with copies of resources, documentation from her preschool teacher, and ready to hear the worst - that we were "wishing" our child was gifted, but that he still felt we should try to put her on medication "just to see."  In reality, he diligently listened to our information, agreed that it is possible she fits into the profoundly gifted category of students, though she may have ADHD too.  However, his response this time was that "time will tell," and I am okay with that.  Through this brief, yet intense process, I have learned that time is the only thing that will give me an answer.  We will have to see if SC's emotional maturity levels out, or if she continues to struggle.  We talked about having her IQ tested, but he said at this point, it would just be for our own, personal reference, and to wait to spend the money if we need it for a school in the future.  Right now, we are comfortable with our decision for next year, to continue with the Mothers' Day Out's kindergarten program two days a week and do supplemental homeschooling the other three days.  We are lucky that the State of Texas does not require kindergarten and we will get another trial year before the decision seems real.  AC and I are still unsure about our long-term plans, but we may never be able to make a long-term decision with SC.  It may always be trial and error, see what will be best for her "now," and as much as I like to plan, I am okay with that.

*For anyone else who has a child who seems "ADHD" but also is displaying signs of giftedness, whether it is intellectual or talents, I would highly suggest reading the book Misdiagnosis and Dual Diagnoses of Gifted Children and Adults by James T. Webb, Ph.D., et al., as well as checking out SENG (Supporting the Emotional Needs of the Gifted), which also has quite a few resources specifically about the ADHD vs. gifted child dilemma. 

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