ADHD in Teen girl or just typical teen?

[scottmel]

My DD14, soon to be 15, has always been a stellar student. She attends a private school that is so demanding. She transferred here in 7th and is currently in 9th grade.

The only grade she struggles with is Algebra. And the mistakes are careless. Simple math mistakes that she doesn't catch and therefore whole problem is wrong. She has suffered with this beginning in Pre A in 6th grade thru Honors Alg 2 in 9th. Again we can't be great at everything and she is an A student but in math more like 88/89 percent. Still great.

Over the summer I read an article about a math learning disorder and called my public school to have her tested over the summer. Turned into a big 5 hour long IQ test. IQ is high, all scores have her in 99 percentile for everthing except math. That was more around 82 percentile. Fantastic case closed. The psychologist that interviewed her said her working storage while average for a normal 14 year old was quite low for her with her other high scores. Did I ever feel she had ADHD? Ah no never crossed my mind but I filed it away. He said that was the only point of interest on the entire 5 hour exam.

Fast forward to 9th grade. She did GREAT the first 9 weeks of school. Used her planner, performed well in all except Biology. To which the teacher called me and said she drifts, loses focus etc. PEp talk to her took her next test score up to a 90. Algebra teacher said she has more potential but easily distracted let's move her to the front. Algebra STILL Not a strong test but ended the 9 weeks with a solid 90 percent, which is a B.

In the meantime she has gotten super moody to which I relate to lack of sleep, though she does get about 7 hours on a school night. And sometimes cheating on her gluten free diet which does affect her moods. Her pediatrician referred me to an ADHD specialist based on my questioning the teacher's comments along with the summer testing.

The scales they have us complete I feel are so subjective. She said DD put herself at borderline ADHD and I had her at definite ADHD based on the scales which again I think are subjective. She is currently inverviewing teachers etc.

My worry is this - how do you KNOW it is ADHD and not typical teen tiredness, boredom etc. She can stay on task decently well at home. However this past week was a disaster - forgot homework 3 times, forgot a test was next day but crammed night before and was ok. Admiteed to just not using planner. But realizes this is crucial and is now doing so.

If results from teachers come back saying yes she has signs, etc. - can you teach teens now to use that planner, get organized at home, etc etc. - I guess I am trying to ask if meds are ESSENTIAL or can corrections to this be self taught? She has had little blips in the road over the years 6th grade with no planner, got her back on track. New school 7th grade flawless year (aside from struggling in Pre Al)...

Sorry so long...just trying to give you all the facts.....

 

[kirstenb1]

Our 15 yr old was dx'd when she was 8. I told the psychiatrist that I could tell dd to go get dressed, find her sneakers, because we were leaving for Busch Gardens (she loves BG) in 30 minutes. 30 minutes later, I'd find her in her room still in her pajamas.

The doctor said that was a perfect example: even when highly motivated, people with attention issues will still get distracted.

 

[mistysue]

What is your end goal?
Just from the information we have, it sounds like you have a child who is getting a B in the honors version of a class most kids don't even take until they are 2-3 years older than she is. Then most of those kids still don't "get it" or do as well as she is doing. Correct? If that is her at her worst, unless you are facing some very significant issues you didn't mention I wouldn't even consider medications. If you end goal is your daughter having the highest possible GPA, but there is no sign of need in the running of her day to day life, please step back and consider the long term effects of medical treatment before starting any sort of medication. While many people take them, the drugs for these things are dangerous. They come with risks that are life threatening and could change your body's natural chemistry forever. It sounds like your DD is in a situation where if she has an attention disorder, she seems to already be managing it well.

Maybe your daughter isn't that into math or biology. That's ok. The fact that a pep talk got her to do better in Biology suggests to me that either she just didn't care about the class, or knows how to handle her attention deficit herself. One of the issues with a disorder like ADHD is that you can't just turn it off, so her just "snapping out of it" and paying attention in Biology makes me skeptical that it's an issue requiring medical intervention. Also true is that some people just don't do as well in math as others. My DH is a math professor and has had completely brilliant students who can try as hard as they want but just don't do well in certain types of math.

From what I read here, if you really suspect she has an attention deficit, long before I looked into medication I would just give her attention based games. Lumosity does that. DH and I have been using that for a couple months and have both noticed a difference. You tell it which things you want to work on and it gives you themed activities for the skill you want with attention being one of the options.

With the example the PP gave, that may be a good question to ask yourself- does she only have an attention problem with the subjects she doesn't care for? Or is this something that effects her life and just only shows up for the subjects she doesn't care for? Those are two very different sets of circumstances, though I am not certain either necessarily requires medication if her lowest grade is a 90%. 90% may not be as strong as you want, but that is a strong score for honors algebra 2 especially at 14.

 

[bookwormde]

There is really nothing in your description that would indicate ADHD.

Perhaps a little ADD, but more likely a combination of and executive function differences and poor instructional practices, particularly in individualizing for her needs.

It sounds like for math that she has never been properly instructed as to methodologies of checking her work, otherwise these simple computational errors would be self corrected.

A formal EF curriculum maybe avid would likely build those linear organizational skills

 

[scottmel]

OP again.

Oh please understand I am doing cartwheels at a 90. I personally wouldn't think ANYTHING of it and scoffed when I heard ADHD. THis specialist however worried me by saying it is classic ADHD when they are unable to tune out the background noise and focus and normally that happens in subjects they are not interested in. She concerned me when she said if left untreated it leads to depression, anxiety etc. and based on her scales she is a highly anxious child. I ASSUMED she was anxious but arent' all teens? I have no other children but to me worrying about attention or what someone thinks of you etc. etc sounds like normal TEEN stuff to me. However per the Dr. based on the info she provided on scales she had ADHD tendencies.

I am in no way for medication. I understand it has it's role in life but if not needed I don't want her to be on it. I just got worried when Dr. said around this age the frontal cortex comes to life and that is where organization, focus etc. come to life and she was able to skate thru life up until now when she had to juggle 9 courses...I argued she just made Magna Cum Laude honor roll but still was told that doesn't matter. Focus does and it can get worse IF that is what this is....

 

[WheeledTraveler]

I'd say that there's a chance that she has ADHD-inattentive type (there is no ADD as a formal diagnosis anymore, just ADHD-hyperactive and ADHD-inattentive). I agree with bookwormde, though, that it sounds to me far closer to executive functioning problems. Weird question that could actually be related, but is she messy? Also, you talk about algebra, but how does she do with geometry?

Your daughter reminds me quite a bit of myself at her age. It wasn't until I was most of the way through college that I was diagnosed with having severe executive functioning deficits. The neuropsychologist who did the testing said that if I hadn't been ridiculously smart for everything else, she'd probably have seen me by the time I was 8. (I was 21.) The problem at that point was that it's much harder to learn the skills you need when you're most of the way through college. What had started to clue us in was the fact that I went from being a generally very good science student to barely passing. I was fine with labs, but tests and quizzes went horribly. Along with some issues with things like checking work in math (I recently took an online calculus course just because I'd enjoyed calculus in high school and I still have issues with it even when I go back and try to find any problems), my main problems come from filtering information. If you give me a paragraph from a science text and tell me to highlight the important points, I'll highlight almost the entire paragraph. Up until I hit AP Bio in high school (which I ended up dropping, but we thought the issues were more related to fatigue from my physical health conditions), I could pretty much memorize a science text book. I got to college level science and all of a sudden I couldn't do that, but had never learned how to filter information or really study.

I'm not sure if the condition you found as the math-related learning disability was Non-Verbal Learning Disability, but my learning disabilities are almost exactly that. The only reason I'm not diagnosed with NVLD is that I'm good with maps, according from the neuropsychology reports. There are definitely ways to deal with it and other executive functioning deficits without medication (and there isn't any medication for it anyway). Quite a bit of it is really repeatedly working on study skills, but some things really only can be managed by using accommodations. If we'd known early enough, I probably could have managed college level science with access to a notetaker and/or the professor's notes which would highlight what the actual important info was. Or, at least, I think I could have. The neuropsychologist was not at all convinced (her report specifically says that I may never succeed at college level science and math), but as I said I really tested out as severe. I don't actually have an official IQ number because the difference between the verbal score and non-verbal score was so big that it's considered too different to get an accurate total IQ.

There are no fully objective ways to diagnose NVLD, ADHD, or many other learning disabilities. It's generally a combination of neuropsychology testing (which generally includes an IQ test, but also can involve other testing), parental reporting, student (if old enough) reporting, and school history. The neuropsychologists I worked with was given copies of all my report cards and as much graded work as we could find, going back to kindergarten. They used that to see what issues were that we might not have remembered. It's interesting because after being diagnosed and reading the report, I could actually look back and see where comments from teachers clearly showed signs that I had executive functioning deficits, even when my actual grades were quite high.

It's expensive, but if you're not happy with the testing the school did, it may be worth paying for a private neuropsychological exam. I don't think my parents and I have ever regretted having them done. I actually had 2 done about a year apart because the original one had missed some things with my physical health that actually hindered my getting an accurate diagnosis for my physical problems so my psychiatrist wanted one that was more accurate on the physical side of things. The nice part is that because they were so close, the second neuropsychologist didn't redo the IQ part of the testing. That meant that we could focus on where we knew the issues existed and do our hours of testing specific to those (it was still 5 or 6 hours of testing total for that neurospychologist, just some of the tests were different).

 

[mistysue]

THis specialist however worried me by saying it is classic ADHD when they are unable to tune out the background noise and focus and normally that happens in subjects they are not interested in. She concerned me when she said if left untreated it leads to depression, anxiety etc. and based on her scales she is a highly anxious child. I ASSUMED she was anxious but arent' all teens? I have no other children but to me worrying about attention or what someone thinks of you etc. etc sounds like normal TEEN stuff to me. However per the Dr. based on the info she provided on scales she had ADHD tendencies.

I am in no way for medication. I understand it has it's role in life but if not needed I don't want her to be on it. I just got worried when Dr. said around this age the frontal cortex comes to life and that is where organization, focus etc. come to life and she was able to skate thru life up until now when she had to juggle 9 courses...I argued she just made Magna Cum Laude honor roll but still was told that doesn't matter. Focus does and it can get worse IF that is what this is....

One of the funny things I've noticed about specialists, is often it seems like once you go to them they are all going to find something wrong. If inability to pay attention to a subject you have no interest in is classic ADHD, I don't think you could find a person on the planet who doesn't have some amount of ADHD.
The ADHD/depression link is also a double edged sword because nearly all of the medication options also have depression as a side effect. If my DD misses her medication for a day she will be moody and angry for about 3 days.

It is true that puberty can really change our natural chemistry, so it's possible for something like ADHD to just show up but at least to me your DD sounds more like a girl who just has some subjects she isn't as interested in. Has your DD had an actual study skills class? She might benefit most from a basic "how to organize yourself" or as WheeledTraveler says maybe looking into her ability to differentiate which facts are important. Some people see a forest, some people see trees, and some people are so busy memorizing every branch on every single tree they can't acknowledge anything until they get every single leaf counted.

I was also serious in suggesting lumosity. It is fun, you can go to the site for free and it will let you play without tracking you. I think we paid $80 for a 5 person one year membership as a family and it tracks each of us and all of our scores. If your concern is attention, she can select to play attention based games. It's like joining a gym to exercise but it's your brain and not your body.

 

[scottmel]

I was also serious in suggesting lumosity. It is fun, you can go to the site for free and it will let you play without tracking you. I think we paid $80 for a 5 person one year membership as a family and it tracks each of us and all of our scores. If your concern is attention, she can select to play attention based games. It's like joining a gym to exercise but it's your brain and not your body.

thank you I will most definitely look into this! Funny thing, last year two subjects she found boring were Latin and History. Ended up with B's in both but oh the groaning and moaning. This year those are her two favorite classes b/c they are both taught by a very energetic teacher who really engages the class. To me personally I think it is more boredom I don't like it - however - I still feel she needs to focus even if bored. I did and do! No study skills offered and believe me I looked at our local community college for a college summer course on it. Nope. Ended up buying a 100.00 CD program that she took to, agreed with, understood but was it super effective for her? No.

 

[Schmeck]

A teenager needs way more than 7 hours of sleep, BTW - more like 8 1/2 - 9 1/4, depending on age. Lack of sleep can manifest in ADD-like ways.

 

[scottmel]

A teenager needs way more than 7 hours of sleep, BTW - more like 8 1/2 - 9 1/4, depending on age. Lack of sleep can manifest in ADD-like ways.

Agreed but going to bed at 8 pm isn't an option wish it were!

 

[Kellykins1218]

There's no way my ADHD child could excel in all subjects but one. If anything, it would be the complete opposite. Maybe she's just not good at math. I got amazing grades in every other subject but as I got older I just couldn't grasp Algebra. I literally got 100% in every other subject but barely passed math. The "new math" is even more confusing.

 

[Dreamer & Wisher]

I have a 9 year old boy with ADHD in attentive type and I think it sounds like your daughter has some of the same symptoms. He is very forgetful, hyper verbal, impulsive, he daydreams a lot and is very creative. He cannot follow 2 step directions. I can not tell him put your pajamas on and then go brush your teeth. He will get completely distracted and do neither.

We have decided to use medications to help him with his symptoms after speaking with a counselor.

My sister and brother have ADHD and my sister said medicine really helped her focus at work. My brother started smoking while still in high school, he never went to college and is now a truck driver.

My sister graduated from college with a degree in finance and worked as a credit analyst for many years. Now she is a stay at home mom to twin girls.

I offer them as examples because the counselor told us that teens with ADHD are more likely to self medicate with cigarettes, alcohol, or illegal drugs.

ADHD students are also usually very intelligent. And girls are more likely than boys to go undiagnosed.
If I were you I would wait and see what the teachers say and find out what your daughter thinks. Ask your pediatrician what he/she thinks as well. If you decide to try a medication keep in mind that not all kids do well with any medication. My son had good results with a medication for many years but then started to get terrible headaches. We switched him to a different medication and is doing much better. My niece does well on an entirely different medication.

Your daughter may be able to cope with her symptoms without medications. Sometimes caffeine is the only thing a person needs to keep their mind focused.

 

[LockShockBarrel]

I have ADHD, was diagnosed at 17 and did crappy in math too. It's boring. Maybe its time to take a step back and put things into perspective? She's a above average student and that's fine. Having a "formal diagnosis" doesn't necessarily mean anything is going to change in the long run.

 

[bookwormde]

I understand as a parent when a so called expert says something we jump.

Either this "expert" had not received any modern training in the last 10 years, or does not think it is important to differentiate between EF issues, either way, go find someone who is competent if you want to get good info.

I also agree that lack of sleep can have a major impact on EF issues, as can anxiety and stress, overload or even love.

 

[Schmeck]

Agreed but going to bed at 8 pm isn't an option wish it were!

She has to get up at 5 AM for school?

 

[scottmel]

She has to get up at 5 AM for school?

Yep. 6:02 bus to catch.

 

[North of Mouse]

Having raised a daughter also, there is absolutely 'nothing' in what you wrote that is not typical in 'most' teens!

Sad that some Drs like to 'pigeon hole' kids for normal behavior that falsely follow them all their life - especially younger lives, and IMO mess them up with unneeded medications.

They (his teachers) tried that with one of my sons, telling us they were sure that was what he had and needed testing). Thankfully I had a pediatrician that saw through what the teachers were telling us and told us he was perfectly in normal range for his age. He was - that was several years ago.

 

[Minniesgal]

A teenager needs way more than 7 hours of sleep, BTW - more like 8 1/2 - 9 1/4, depending on age. Lack of sleep can manifest in ADD-like ways.

Totally agree 7 hours sleep is not nearly enough for a 14 year old particularly one who is exhibiting some of the signs of ADHD.

 

[lost*in*cyberspace]

I have to agree that it's doubtful your daughter has ADHD. I am very familiar with this, and your daughter doesn't fit the diagnostic criteria. Additionally, with a kid who is really ADHD, you would have noticed the symptoms at a much younger age. There is something else going on, either typical teenage behavior or something else. I wouldn't even think about meds until she has a thorough evaluation by a competent psychologist/psychiatrist or pediatric neurologist.

 

[scottmel]

OP again. THank you so much everyone. So wonderful to get such a vast variety of opinions. Having only one child is tough in the way of not knowing WHAT the heck normal looks like!!! To me she seems like the typical mood of a teen - up and down like a roller coaster. Some days great, some days GRRRRR and the days that are the toughest are the days she is up at 5 AM. Even on weekends she can't sleep in much (well she goes to bed later and sleeps till 9) so she isn't piling on extra sleep on the weekend.

I will be anxious to see what her teachers report back on. To me they have seen many many students over the years and would be a far better judge of normal teen behavior than I would be.

I just hating reading the stats on teen girls getting misdiagnosed and later leading to depression, higher suicide rates etc. It was scarey! I figure anyone that can sit thru advanced latin (which honestly has to be a snore) and get a 97 on Friday's test has got to be engaged. I realize a teacher makes HUGE difference for her - a good one captures her attention and a less animated dry one loses her. But geez I would react the same way I would think!