Can you have only SOME symptoms of execute function problems in ADD?

Discussion in 'General Parenting' started by MidwestMom, Jun 13, 2011.

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  1. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    I took all of your advice and looked up executive function disorder, and it seems to go with ADD/ADHD.

    She has every single deficit except behavioral ones. She is actually very smart about behavior and does think about consequences: "No way will I ever smoke or use drugs. That's stupid, especially since I'm an athlete." She is not particularly impulsive. She does not act first, think later...I am very confused. But everything else fits. She forgets her things at home and I have to bring them to school. She loses things. She turns the house upside down looking for things, then finds them in her school locker. Her room looks like Hurricane Katrina. Her brother will help her clean it, but a week later it looks the same. She doesn't do a very good job of knowing where to put things and when she cleans herself, the room has things stuffed in the closet etc. She has a good memory for things she has done physically, but a poor one for remembering facts and math formulas. Trying hard doesn't help her.

    Does this make sense to anybody?

    Also, it says these kids learn best with visuals and with word prompts that they can remember.

    Sorry to keep posting. I'm just now learning how bad a problem Jumper has. She could get by until high school :/
     
  2. AnnieO

    AnnieO Shooting from the Hip

    Sweetheart - hugs. Yes, it's bad - but it can be worked through. She can (and I'm betting WILL) learn strategies to get around any shortcomings and highlight strengths.

    And I don't see why every single person with ADD would be the same with respect to executive functioning. They're not clones, they will be different.
     
  3. flutterby

    flutterby Fly away!

    You're only going to ever see some disorders of executive function. If all executive functions were effected, the child would be non-functioning. So, the answer to your questions is yes.

    With the working memory for my difficult child, she has to see something at least 3 times before it even looks familiar. Repetition, repetition, repetition - and the more complex the problem/thought process, the more repetition is needed. However, her rote memory - regurgitating information - is high average.
     
  4. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Thanks. Makes sense. I get thrown off because I keep reading that executive function problems mean impulsivity and poor social skills. It's so puzzling. She has never been impulsive or moody, has never thrown a tantrum in her life, and is very level-headed and successful in social situations.

    But she can't figure out how to clean her room.


    Puzzling. (I am glad I don't have to see her locker at school...lol).
     
  5. AnnieO

    AnnieO Shooting from the Hip

    MWM?

    I had problems with room cleaning too.

    I learned... AFTER I moved out.

    :hugs:
     
  6. InsaneCdn

    InsaneCdn Well-Known Member

    First - yes, you can have all sorts of combinations and permutations! And then you add in the other co-existing stuff, and... its a "puppy-dog's breakfast".

    "She has a good memory for things she has done physically, but a poor one for remembering facts and math formulas. Trying hard doesn't help her." This sounds like working memory issues to me... (me, K1, etc. etc............ ) Just wondering... did it get a lot worse when she hit highter grades?

    Here's one possible explanation...
    1) She has a deficit in the "planning/organization" executive function.
    2) She is a hands-on learner - can learn a process but not facts and formulas and detailed minutinae.
    3) She has a working memory problem... she can't remember where she put something - as soon as its out of sight, it might as well be on Pluto... and she can't remember what the organization structure is, so doesn't have anything to mentally "hang on to"
    4) She's getting into higher grades, where there is SO much more to keep track of and remember, that her working memory is overloaded long before she gets around to dealing with "stupid stuff" like keeping a room neat...If that sounds at all familiar...

    - SIMPLIFY her room. These kids hate it, but you have to go there. Summer is a good time to do it - there's too much on their minds the rest of the year. Think 3-year-old - not in colors and decorating schemes, but in terms of things that a 3-year-old can "organize". Get rid of dressers, desks and other drawers... use BINS, labelled with pictures, on open shelves... "socks", "t-shirts", "jeans", etc. A TABLE instead of a desk, so nothing "gets lost inside". Limit what has to be "hung up" - obviously, dressy stuff and anything that wrinkles. Otherwise, FOLD. Room still looks better if jeans are stuffed in the appropriate box than tossed just anywhere. Use cork boards to post up visual/visible lists - the "stupid stuff"... Clean room = (check-list..., or basic rules - in our house a room is "neat" if it is ready for the housekeeper to vacuum, dust, and change the sheets, and all the dirty laundry is in the laundry bin)

    - SIMPLIFY her life. Find out what kinds of details at school are driving her nuts. Then find ways to support these VISUALLY. Color-code her schedule, with matching binders. Anything that takes organization out of "working memory". Then start researching "working memory" and see what else can be applied at school - because school will be using up most of her resources.

    - BUY extras. Our kids couldn't figure out where the plates etc. went in the cupboard, because the stack would all be in the dishwasher... so we got more plates, bowls, etc. so that there is always at least a couple left in the cupboard. They won't take time to look at the "map" when unloading, but they DO make use of the "match the item" game... and I can still find everything. Ditto for socks, underwear, pens. paper supplies, etc.

    - Anything that is prone to getting "lost", needs a home that is NOT in her room. One of our kids has to leave backpack in the dining room... so it doesn't get burried under stuff, or kicked over and stuff spills out, or stuff added to it that doesn't belong there... In the dining room, the rest of us can look out for the pack! Smaller stuff - cell phone, usb keyfob, etc. needs a TIEDOWN - use carbiner clips or equiv and elastic thread - they can take it out of the pack, but if the elastic is long enough, they won't need to do that very often... cell carbiner can be clipped to belt or whatever, if pack not available (or not cool).

    Just some ideas... there's lots out there on the net on ADD and organization... I'd post you some links, but I can't remember where I filed them!

    Good luck.
     
    Last edited: Jun 13, 2011
  7. DammitJanet

    DammitJanet Well-Known Member Staff Member

    mwm...

    Jamie wasnt very good in HS because of the way they taught with lots of talking and boring work. It was kind of like the teacher in Charlie Brown for him too. Now he did manage to bring home C's but barely and that was without his ritalin because he was going it alone to get in the military.

    Now oddly enough when he got into the Marines, they taught in a totally different way and he made straight A's. He has had to learn a ton of information since he has left HS and he has not had any problems because they dont teach like they did there. At least in the area he is working in, he is taught in a very hands on...here is the info...regurgitate it back to me..show me what you have learned...very good...you have learned it.

    He doesnt have to know every state penal code by heart. He has to know how to look them up on the computer in his truck. He knows how to use his equipment and handle people and animals. He knows how to fire his weapon.

    That is how he was trained. Hands on and totally told the important information straight forward...basically like the old Dragnet show..Just the facts.
     
  8. idohope

    idohope Member

    When difficult child had neuropysch testing she was indicated to be in the "expected", "above expected" or "well above expected" in many of the categories of Executive Function. She had a high ability to focus and sustain attention. However, she was slightly below expected or mildly impaired in a couple, specifically those related to working memory and ability to learn and retain complex information. The neurospych stated in the report that given difficult children strong intellectual abilities that weaknesses in even the slightly less than expected range indicate significant weakness for difficult child and should be considered a processing disorder in that area. difficult child is not diagnosed with ADD but clearly has some executive function issues. Her room is a disaster, she can never find anything, missing school assignments. Hopes this helps to clarify that people can certainly have some aspects but not all.
     
  9. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Thanks, Idohope.

    Daughter has never had her memory tested. This should be interesting. By her ability levels, she should be able to do the work, but the best she can do with trying her best is 3 C's and a D+ in her core classes. In her case, I believe she does have ADD, but I also think she has some executive function issues.

    Tomorrow is her neuropsychologist. We waited five months to get her in. Should be helpful.
     
  10. KTMom91

    KTMom91 Well-Known Member

    Miss KT is hyper-organized (almost Obsessive Compulsive Disorder (OCD)), and has fits if stuff is not put properly and neatly away exactly where it belongs. Hubby could care less, and is a borderline hoarder. Miss KT can't find her way out of a paper bag (Remember when she got lost off-campus, and ended up driving around the local psychiatric ward? Called me, who was 300 miles away, for directions, and then forgot all her trauma when she noticed a Chipotle), but Hubby has an excellent memory for places and directions. Miss KT is an auditory learner (weird, I know) and Hubby learns by doing. They both HATE to read.

    Executive functioning deficiencies can manifest in many different ways. I think it's a matter of learning to cope with and/or overcome the deficiencies, which would be different for everyone.
     
  11. Marguerite

    Marguerite Active Member

    The neuropsychologist appointment should show up the problem areas. Explain your concerns in detail and that should guide them to which tests focus on.

    She is a girl - that makes a difference in how it is expressed. As in Asperger's, ADHD is also much more complex in girls.

    I have said for years, males and females think differently. Men think in straight lines, women think in spirals. By this I mean that men mentally tend to go directly from A to B, while women take a bit longer to get there but take in the scenic view and have a broader perspective on the related issues. As much of the understanding of ADHD and Pervasive Developmental Disorder (PDD) comes form studies of males, when you have a female with any of these traits, you find some odd and surprising things.

    Women tend to be more socially capable than men; just look around the next barbecue you attend and listen in on the conversations. easy child 2/difficult child 2 is, we believe, Aspie. She is very sociable, has a number of very loyal friends. She is at times inappropriate socially, gets a bit difficult sometimes (pedantic and annoying with it) but generally can over-ride and behave herself well, knows how to be kind and polite even when she doesn't feel like it. She has not performed on stilts since before she married, but it is something she was doing professionally from childhood. I have seen her tired after a two hour gig, suddenly turn towards an approaching child and flash a dazzling smile and engage the child. She is amazing in her drive and determination to fit in socially. Even at her last gig there were times when she would sit down to adjust her stilts, and was approached by large groups of people asking how she idd it - she showed them, she talked them through it then she got up and walked around for them, engaging the kids all the while. And I knew her legs were hurting because the stilt brace was needing adjustment.

    Girls tend to be able to 'slide by' more, socially. Plus other girls can sense the innate honesty and generosity of spirit, and love them for it. The girls who are spiteful to them are the ones who feel they are "too good to be true" or who do not appreciate the occasional brutal honesty. easy child 2/difficult child 2 does brutal honesty with devastating brilliance. She had her enemies, they tended to be the duplicitous, sneaky girls. The decent kids generally were her friends.

    Later in life the innate loyalty and honesty will bear fruit.

    I know I've combined discussion of ADHD and Pervasive Developmental Disorder (PDD) here, but this is an area where you get some overlap. I know Jumper doesn't have Pervasive Developmental Disorder (PDD) but I'm betting that there are a couple of traits mixed in with the ADHD. And with any traits - you get the good stuff too. And there is a lot of good stuff, as I am sure you are realising.

    Does this help?

    Marg
     
  12. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Marg, it makes sense, but, as autistic sensitive as I am, I can't see anything Autism Spectrum Disorders (ASD) about Jumper. I would be the first one to jump all over it if I saw any overlap. I can't. I'm sure no trace of it will show up tomorrow. I can't explain it other than to say if you knew her, you wouldn't see anything either. I do believe that ADD girls are quieter than the boys and have a lot less "H."

    Tomorrow is the day we get a few answers. Unfortunately, because the testing takes so long, we won't get the complete results for a couple weeks when we will have to go back. And the written report won't come for a few weeks after THAT.
     
  13. Marguerite

    Marguerite Active Member

    I know she isn't autistic in any way. You and I would be the first to recognise it in another child of ours. But there are a lot of differences between each child on the spectrum, as well as a vast amount of overlap between Autism Spectrum Disorders (ASD) and other conditions closely related to the spectrum (such as ADHD). And especially or girls, the lines get even more blurred and confused.

    I'm suggesting your working hypothesis be atypical (because she's female) ADHD with some related traits that can be similar, superficially, to mild Asperger's. NOT that she has Asperger's, but only those aspects of it that are part of ADHD. That would account for her sociability and popularity. Remember, my borderline Aspie is a social butterfly with a lot of very loyal (non-Aspie) friends. She is so socially capable that she wants to be a teacher, is doing very well in her understanding of child psychology in her coursework. She also went through a stage of struggling with Maths, very similar to what you describe with Jumper. The difference for us - dexamphetamine helped overcome the problem. easy child 2/difficult child 2 has gone on to coach other kids in Maths, she got so good at it. One year she was failing. The next year she topped her class in Maths.

    The only Autism Spectrum Disorders (ASD) overlap that I see as possible here, are the multi-tasking/memory issues you can get in some cases. This feeds in to poor personal organisation. But never discount the positive qualities that are possibly Aspie - the honesty, the loyalty, the "straight as an arrow" mind. And you can get these in ADHD, in the absence of Autism Spectrum Disorders (ASD).

    My benchmark in this is easy child. Definitely not Autism Spectrum Disorders (ASD), not even ADHD - but at times impulsive, at times anxious, at times very dogmatic about things being done as she says they should be done. Socially - always popular, good at connecting with people. And boy, does she cheat at cards! She can run rings around her siblings who don't pick up on the cheating.

    Marg
     
  14. idohope

    idohope Member

    MWM: Good Luck with the testing. I know about the wait, it took us 8 months to get in and then it is hard to believe when the time finally comes. In retrospect, nothing earthshattering happened after we had the results. But it was a big piece of the puzzle and information to try to figure out difficult child and how to best help her. It was good for me to go back and read the report, so thanks for your post.
     
  15. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Well, she went to the appointment. The neuropsychologist is young and highly intelligent (graduated from one of the top colleges in the country) and I think we WILL get a lot accomplished. He understood how she can read fluently but not understand what she reads. He understood how she could study for two hours right before a test then have to take the test and forget what she had just studied. It did not throw him at all. She took her third TOVA test (the computer test for ADHD) and said she almost fell asleep taking it...lol. Hub and I had to fill out three long forms. We will find out the results on the 20th, but she was in good hands.

    Marg, when I said, "She isn't on the spectrum, is she?" he looked at me funny, then laughed and said, "No, she's not on the spectrum." :)

    From filling out the forms, we could see that she was going to score in the "very normal" area in almost everything, BUT the BIG exceptions are remembering, organizing, being able to start projects without help, being able to pay attention, understanding reading and math...all academic/attentional/organizational. I actually think that, since her behavior is so normal, she'll do well on the executive function test too, except for the exceptions I noted.
     
  16. Marguerite

    Marguerite Active Member

    I don't think she is on the spectrum either. But the problem you describe are sufficiently similar, that sometimes the same techniques we use to support a child who IS on the spectrum and has this sort of problem, can help her too.

    if you can, dig into the sub-sub-scores, the fragments of the sub-tests that can break the problem up further. The more detail that can be provided, the better.

    For example in difficult child 3's recent test, his score in problem-solving was not much above average. But his non-verbal problem solving was in the 99th percentile. It was the verbal score (which relied on memory) that dragged his result way down. So within this sub-test, he had a wide spread of splinter skills. The neuropsychologist was a good one, plus she had set up her testing to specifically measure what I was concerned about. She specifically studied memory in as many ways as she could, and identified the problem as far as she could. And now we have to find a way to use this information.

    Marg
     
  17. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Thanks, Marge. We will.

    Jumper is having a working memory test...as well as probably every test possible under the sun. the neuropsychologist is very very intensive and good. I'm sure he'll finally be able to tell us what is going on. This is not just about IQ tests and he says she will not show up as Learning Disability (LD). He seems to know what is going on, but he takes a long time before giving the results. He grades the tests, takes all our own worksheets that we filled out into consideration, and really works hard on it. I am hopeful :)
     
  18. InsaneCdn

    InsaneCdn Well-Known Member

    Marg said:
    We've been told by some "experts" who's opinions we trust, that things like ADHD, executive functions, working memory, sensory issues, motor skills challenges, social issues, etc. etc. are all related. So, it isn't unusual for a child with anything in this range of issues, to have other related issues... NOT necessarily to the diagnostic standard.

    Our K is definitely absolutely NOT on the Autism Spectrum Disorders (ASD) spectrum - no where close to meeting clinical standards. BUT... on 3 or 4 specific sub-tests, he hit "clinically significant scores"... so, we know that we're going to have to learn more about how these affect him and how these need to affect our responses and interactions with him.

    Get the DETAILED scores from the testing, in addition to the verbage report, if you can - the details are absolutely critical, and not every expert tester sees all the details as significant - but someone else who reads the report, might. (been there done that... )
     
  19. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Thanks InsaneCndn, from InsaneWisconsinite here :)

    What they do is mail out a ten page report with all the scores and subscores and before that we have an hour meeting where it is all shown to us and talked about as well. by the way, I agree there there is a lot of overlapping of symptoms in disorders and it's jut the neuropsychologist's best guess. But because of the neuropsychologist testing, in detail, her working memory and inattentiveness we will find out where she needs help...and this should aid her summer tutor a lot as well as the school in her next year.

    Thanks for all the help, guys. You never fail to amaze me.
     
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