social intelligence | ADHD Information

If I haven't told you yet to take her to a NeuroPsych to evaluate her for ASD, I'm telling you now. ASD kids, more than ADHD kids, don't understand give and take conversing and get very bored when they are not interested in the topic. If you don't test her, in the future, I'm betting you'll regret it. This sort of social cluelessness is far more common with ASD. ADHD kids deficits are not as glaring. I would dump the psycologist, who likely knows little about ASD or how to test for it and see a NeuroPsych, even if there is a waiting list. Your child isn't just having social problems, she is failing to "get it", and that's ASD. I deal with this all the time, but my son is on the Spectrum. He gets good help at school.I know it's not pleasant to conemplate, and you seem to not want to even go there, but you can't help your child to the max if you won't see what is really wrong. A NeuroPsych can diagnose ADHD and beyond, and you should have a better picture after you see one.I have a site you may want to post the same message to:

www.autism-pdd.net/forum/default.asp

MomWI38905.8095833333

Since school has been out (early June) dd has been pretty anti-social. She didn't want to play with anybody, including me or her sis. I was getting rather anxious about this. So last week we were on vacation with their cousins. They played 24/7 for a week. I was hoping it would snap her out of her loner funk. I think it did kind of break the cycle. She played with our neighbor yesterday and today actually called a friend to come over and they played about 4.5 hours today. And it actually ended well!

One thing I noticed, though, is that she is still unable to have a conversation of more than 2 sentences. Her friend was trying to tell her about a vacation she had and dd just couldn't pay attention at all, while lil sis was thoroughly engaged and asking questions, etc. and showing interest. I even pulled her aside and told her to pay attention and listen to her friend and to even ask a question about what she was saying. But she just couldn't. After the playdate, I sat down with her and read her a couple of books about how to be a friend, and then role-played a bit on how to carry on a conversation and how to ask appropriate questions. I just don't know if this is going to be enough. These things I try to teach her just don't seem to stick. I hope the psychologist we will be seeing for the first time next week can help us with her social intelligence. The next time she is in a conversation with someone, she probably isn't going to be able to recall these rules for conversation in the heat of the moment. Sigh. Anyone else here deal with the same thing?

I agree with MOMWI. I was going to suggest the same thing. My sons original diagnosis was ADHD, with some anxiety, and a little depression. After all the meds we tried failed, he was sent to a psychiatrist with the possible diagnosis of Bipolar. That was ruled out, as he really doesn't fit that well, and given a diagnosis of ADHD, ODD. A few more medication failures and a few remarks from doc that showed me how uneducated he was in childhood disorders, I dropped him and we are now on our 3rd doctor.

My sons new doctor feels he probably has Aspergers (spectrum disorder), but we are awaiting further testing before a final diagnosis is given. I really believe that this is what my son has. My son fits the ADHD criteria totally. There isn't anything in the criteria that he doesn't fit, BUT there is all this other stuff that he has as well that can't be stuffed under that umbrella.
He is social, but also just doesn't "get it". He really just doesn't get what is appropriate, what is not, and pretty much has one way conversations. He has tantrums and is really over reactive, but I'm beginning to realize that most of these are coming from either sensory things, transitional issues, or him not perceiving a situation the correct way.

6 months ago I would have sworn he was ADHD and nothing more. In fact I DID, and I used to pass by any posts here suggesting otherwise. I regret that now, and wish I would have taken my son to a more qualified person years and years ago, and told them about ALL the things that concerned me, not just the things that were the most pressing at the moment.

I can tell you, from experience, being ADHD myself, that my social issues, and the issues that my son has are totally different. We both like people, we both like to be around people, but I "get it" and he "doesn't". My social issues are things along the lines of letting things slip out of my mouth before I can stop them. Not being able to find the right words at times, being fully aware that there is a pause in the conversation that I should fill in, but can't spit out what I want to say. Stumbling over words. Tuning out of conversations because I'm thinking about something stupid I just said. But I get the general rules of being social, and I get when someone sends me the signal that I've offended, or am being obnoxious, or they aren't listening, etc. I'm just socially "clumsy".

My son on the other hand is socially "clueless". He doesn't see the clues that other people give him that they are annoyed, or bored. Even if they tell him, most of the time he takes that attention as being something good, and just increases the behavior. He thinks certain behaviors are funny, or cool, that totally turn off other kids his age, yet he doesn't see it. He talks and talks and talks, but still doesn't have a "conversation". To get him to stop, you have to say "let me speak please, please stop talking", and you can tell that you have lost him the entire time you are speaking. He is just biting his tongue waiting to continue on with whatever his next thought was.

Anyway, I totally agree with MOMWI. If this is something more, and it does sound like it could be, you really will regret waiting. My son is almost 10 now, and now his self esteem has crashed, his peers are getting further and further away from him, and we have years and years wasted that we could have been fixing.
If it is just ADHD with my son, or with your daughter, then you just get confirmation of that, no harm done. If you miss something more, there can be great harm done.

Just my 2 cent

Amen, LadyM. A NeuroPsych is the best way to go. Since Aspergers has only been recognized for ten years, many "ADHD" adults now walk around clueless, jobless etc. because they got the wrong diagnosis. Hoping it's ADHD when it's not doesn't help the child one bit, as I learned with my own son. Social cluelessness is not ADHD. It's the biggest symptom there is of Aspergers Syndrome. A Psycologist/Pediatrician/any professional who doesn't know the right tests that point to Aspergers (and spend hours doing them) doesn't know much about it and can't diagnose it. I recommend a NeuroPsych..IMac38944.8328819444We have already been to a neuropsych.I resent when some posters read a post and take it to another level, jump to a conclusion and state with an attitude of authority that they seem to know exctly what is wrong. I see this in a variety of places on the forum and it shows up again in this thread. One example... "Your child isn't just having social problems, she is failing to "get it", and that's ASD." The individual speaking does not know "your child" Thank goodness qualified doctors do not make assumptions like this. Some sensitivity and the addition of the word "perhaps" may allow a reader some space and afford the author some credibility. cr12345mr,

I bumped up a similar topic you may be interested in. What lillian describes in her posts seems to hit close to home re ds. It seems to me that the inattention, boredom, random thought patterns may lead to difficulty keeping up with conversation. Perhaps processing issues enters into this as well. Sometimes, it takes ds longer than most people to process and formulate what he is going to say. This is on medication. Off meds he has a quick and impulsive mouth.
jfla

what's sahm and nt?
jfla238906.4394791667

jfla2, thanks for the support. I needed that!

sahm = stay at home mom

nt - neurotypical

Yes, I agree, there is an issue of slow processing. I'm hoping the "conversation practice" will help her. We tried again today, but she of course wasn't feeling very cooperative at the time.

If anybody has any games or things they do with their kids to build social skills, I'd be interested in reading it.

Sorry jfla2, but she asked if anyone else can relate, I could, so I answered :). Sorry that my "related experience" may not be what anyone wants to hear, and I'll never pretend to be a doctor or be able to diagnose over the internet, but if my opinion, or experience with my child, or myself, can help someone else then I like to share. What is posted here never has to be considered, but if it wasn't for people posting other things to think about, I would honestly still be trying to figure out why ADHD medications were not working for my child.
I initially considered not participating in this forum because I was turned off by the insistence in some threads that there may be more then ADHD with some children. Ironically enough those posts are the exact thing that sent me in the right direction to look at what else may be going on with my child.

When someone asks if you can relate though, or they aren't getting results from treatment, or they are lost because things are getting out of control with their ADHD child, then I don't see the problem with sharing other possibilities. I would never want to make someone feel uncomfortable, and I try to be careful when suggesting there might be something more, because this is after all the internet, and I'm not a doctor. But from my own experience, I've become very aware that sometimes mom experience is more valuable then what you can find in the medical community. Sometimes, like in my case, it wasn't necessarily the doctors but the fact that my son had all these red flags, but most of them were not causing major issues for "me", so I wasn't relaying them to the doctors. Yet they are appearing to be a major part of the issues with my son. I wouldn't have known that without reading the experiences of other mothers, and opening my mind to the possibility that "maybe" it was something more, even though my son fits 100% with the ADHD criteria.

I can only speak for myself, but I don't mean any harm, certainly don't want to offend, or hurt anyone, but I would hate to see someone else go down the road I've been down. So when I see big red flags in a post, I would rather make a suggestion, and share my story, then see someone suffer when there maybe something else going on. They may listen, they may not, they may put in the back of their head like I did, and some day down the road recall it and look into it further, but at least the information is there. Doesn't have to be taken, but it's there, for the poster to do with it as they please. I don't think anyone here is trying to be hurtful or rude though, but trying to help other mothers and children not go down the same dreadful road they have been on, when they see someone possibly traveling down the same avenue

Again, just my OPINION.

ladym,
I have never complained about a post before, but I guess i got tired of a repetitive pattern I've observed since i've been a member for almost a year. Personally I did not think that your related experience was presumptous, but merely suggestive which in no case is rude, nor was i offended by your tone. This forum is a wonderful place of tossing ideas around in trying to get help for our often misunderstood, misdiagnosed children. In fact, I was not thinking of or referring to your post in particular. Maybe I'm just put off by less sensitive posts which have a tone containing know it all assumptions and jump in a simple way to what may be unfounded conclusions. I often end up not taking them that seriously.
jfla

jfla238906.4936111111

I always read on this site posts where people are suggesting neuropyschs who will maybe find the child has Asp.

OK, they may also have ADHD too right? I think they are all on a spectrum of some sort.

But if your child has an ADHD or Asp. diagnosis, what's the difference in how you treat them? I mean, the child needs to work on social skills either way. The child has specific social skills to work on that are unique to that child nomatter what his offical diagnosis is. They child will benefit or not benefit from meds. That will be obvious once meds are tried. The child may or may not have anxiety, depression, etc. that needs to be treated.

In the end, maybe someone can help me understand why it's so important to have a diagnosis. Why aren't we more focused on treating a child's deficits and less focus on trying to label them and have them fit in a group. Don't forget, these labels were just created by health professionals sitting in a room trying to group their patients. Maybe in a few years, there will be another label..somewhere inbetween Aspbergers and ADHD. With the explosion of "special needs" children out there, I wouldn't be surprised if a few more labels were created.

Great questions, and a very important one. The main importance of separating the labels is that the treatment is significantly different. Yes, you are right, if they have ASD, they can have ADHD symptoms too, and most of them actually do. Children with spectrum disorders though, need very different treatment then AD/HD children. They may both need social skills training, but the intensity at which a child on the spectrum may need help vs. the AD/HD child is very different.

The thing is, you could take an AD/HD child and give them all the therapies that a child on the spectrum would get and it would probably help them to a degree, but medication is really the most effective thing to treat AD/HD.

The opposite is true of ADS. If you have a child on the spectrum, and treat them with the typical treatment that an AD/HD child would get, you will fail the ASD child greatly because they simply will not be getting the help they need. While medication is extremely effective for the AD/HD child/adult, it may only help certain symptoms with the ASD child, and would never be the main line of treatment.

While many symptoms of the two may overlap, and many treatment may be similar, there is a huge difference in severity between the two, and huge difference in the way they need to be treated. So labels are just labels, but labels also tell us which treatment would be most appropriate, so I do think they are important. Labels also tell us "why" children act the way they do. An AD/HD child may be bouncing off the walls because of the chemical issues in the brain. While the ASD child may be bouncing off the walls because of sensory over load. If you don't know what disorder you are dealing with, they would both look the same, but both require very different treatments. One would need medication, the other needs occupational therapy. Just like my sons "reactive moods" that were being treated with an anti-psychotic. While he most certainly is reactive, I'm beginning to see more and more that his over reactions are sensory based, and no amount of medication is going to fix that. So he still acts the same as he always has, but depending on if he has a "reactive mood", or "sensory integration disorder", the treatment would be very different.

This can be said for many things, like Bipolar, who's manic symptoms often mimic ADHD. They "look" the same, but need totally different treatment. Throw a stimulant onto a Bipolar child, and you are very often in trouble, because they can make Bipolar much worse.

Anyway, that's why I personally think it's important. Others may feel differently though :).

[QUOTE=mellowdancer]

I always read on this site posts where people are suggesting neuropyschs who will maybe find the child has Asp.

OK, they may also have ADHD too right? I think they are all on a spectrum of some sort.

[/QUOTE]

That is a good point. But I also think that there may be an aspberger "spectrum" has yet to be talked about. I think there are some kids that you can spend 5 minutes with and know they are aspie, while obviously not others.

I think one point to make is that adhd kids respond better to social skills training and groups if they have effective medication. This will help them pay attention. But certainly social skills training is effective for both.

You are right, there are different degrees of Aspergers, because it is an Autism spectrum disorder. It's a "wide spectrum", that's where the name comes from. Some children are more severe then others. If my son does have Aspergers, as his doctors think he does, he would not be one of those obvious children that you know right off the are Aspies. Most people just think he is "weird". But given that he has already been through AD/HD treatment and it did not help him at all, and in fact just made things worse...I would be the first to say, the label is important. Even though he appears to be AD/HD and likely needs similar treatment, again knowing he is Aspergers, will change everything as far as treatment goes. Not to mention the fact that he has had 5 different medications (and many more doses then that) in his body that he didn't need.

You are totally correct though that social skills training is a great asset to both :).

If you've been to a NeuroPsych, I recommend a second opinion. My son was misdiagnosed repeatedly. Treating ADHD won't help your child at all if she has ASD. Social cluelessness isn't ADHD. ADHD is treated a lot differently than ASD. ASD is more serious and requires much more interventions for the kids to "get it" and sometimes they still don't. STims aren't the answer for most ASD kids. Finally all ASD kids have ADHD behaviors. To check the differences in treatments (and you'll see BIG ones) check this ASD site, in which many of the kids have Aspergers. ASD is a communication disorder, and ADHD is not. Even if the kids talk well, they can not communicate or converse well or read facial signals or make friends.Without the ASD dx., your child will NOT get the proper interventions, which is why the label is important. Schools don't need to implement ASD treatment/interventions for ADHD because they are different. You may not like labels, but that's how it works. Ditto for adults with ASD. Many need ongoing help, and they can't get services if they're called ADHD. My son also doesn't appear to have ASD yet, living with him, you can tell he probably won't be independent as an adult. Others who see him wouldn't get it, but we know. Many Aspies are on Disability. I have a friend who works in Disability. The key to independence, or a chance at it, are ASD interventions from early childhood straight thru adulthood. Without them, someone with ASD has a poor chance. Even with them, it's often "iffy" as far as independence, but you always want to bring somebody to his/her highest level. Denial is very bad for a child.Good luck and I hope you browse the other site:)

www.autism-pdd.net/forum/default.asp

MomWI38906.8387037037

KarenR,

I'm not totally familiar with the treatment process as he is still undergoing more testing. As far as I know it's very individual based, as each child is so different. A lot of children have sensory issues, like we are sure my son has, so they will have sensory integration therapy for that. We are starting Behavior modification therapy, and I believe this is generally recommended. Social skills obviously would be important, and any therapy for motor development problems, if they have those issues too, which they generally do. Medication is not the first line of treatment, since there isn't a medication for Aspergers. Medication can be used to treat symptoms though, and since many Aspergers children have AD/HD symptoms then doctors will sometimes recommend ADHD meds. Some kids need mood stabilizers for aggression too.

I think it's mainly just based on each child's symptoms, as opposed to being one treatment plan for all.

Again though, I really can't answer this well as I've just begun to look at that side of things.

MomWI,

Have you taken on a nom de plume?

Are LadyM and MomWI the same person?

Oh come on. So I have a similar opinion as someone, now we are the same person?

[QUOTE=NoTellin]Are LadyM and MomWI the same person?[/QUOTE]

Lady M, your son sounds just like mine. What kind of help do they do for ASD kids other than therapy and meds ?I know some people were offended that I dare to bring up Aspergers and bipolar, but it doesn't phase me. If people hadn't told me about them, my son would still be diagnosed ADHD, which isn't the big picture. If one parent gains from my info, it's worth it. LadyM, you didn't do anything wrong. You're telling parents that ADHD has mimickers, which it does, and that if kids main problems are serious social deficits, it's probably more than ADHD. For all those who, maybe because of fear or denial, don't want to "hear" it, there are dozens who do, if not more. I get lots of PM's. Take care and don't feel bad. I didn't let anyone make me leave. If they don't like me, they can skip my posts or leave themselves

.IMac38944.8331481482There are social skills groups that are run by professionals that teach social skills. They teach everything from how to approach a group of kids, to personal space, to dealing with bullies, rejection etc. My son has benefited from that and he has adhd. Now, he is on focalin xr and it helps him focus in school. But I also think in some ways he's socially clueless.[QUOTE=cr12345mr]

Since school has been out (early June) dd has been pretty anti-social. She didn't want to play with anybody, including me or her sis. I was getting rather anxious about this.

So this is unusual behavior for her?

So last week we were on vacation with their cousins. They played 24/7 for a week.

And she interacted well? She likes her cousins?

I was hoping it would snap her out of her loner funk. I think it did kind of break the cycle.

Good. Maybe, she just needed some time to decompress after school was over?

She played with our neighbor yesterdayand today actually called a friend to come over and they played about 4.5 hours today.

Good. That's a decent amount of time to spend with a friend, and your daughter called the friend, so your daughter initiated the social time.

And it actually ended well!

It's unusual for it to end well?

One thing I noticed, though, is that she is still unable to have a conversation of more than 2 sentences.

Always? With her cousins and with this friend or just with this friend?

Her friend was trying to tell her about a vacation she had and dd just couldn't pay attention at all, while lil sis was thoroughly engaged and asking questions, etc.

Why couldn't she pay attention? Was she focusing on TV, something else she was doing, or what? Is it possible your daughter didn't care about her friend's vacation or was jealous of it for some reason?

and showing interest. I even pulled her aside and told her to pay attention and listen to her friend and to even ask a question about what she was saying. But she just couldn't.

Couldn't or wouldn't?

After the playdate, I sat down with her and read her a couple of books about how to be a friend, and then role-played a bit on how to carry on a conversation and how to ask appropriate questions. I just don't know if this is going to be enough. These things I try to teach her just don't seem to stick.

You often are teaching her how to have a conversation?

I hope the psychologist we will be seeing for the first time next week can help us with her social intelligence. The next time she is in a conversation with someone, she probably isn't going to be able to recall these rules for conversation in the heat of the moment. Sigh. Anyone else here deal with the same thing?

Yes. My son behaves this way at times, as do most of his friends. Also, keep in mind that ADHD kids can be highly competitive and easily annoyed. Wanting to be first and the leader is a common behavior with these kids who have the H with the ADD.

[/QUOTE]

lillian,
I appreciate your comments above. Funny, these were my exact thoughts too.

I have a question. When you say your daughter "could not pay attention to her friend," what do you mean? Can you describe this?

There's a few here who think it's smart to test beyond ADHD, not just me and LadyM. Many of us are trying to help other floundering moms, stuck with an ADHD dx. who still have unstable kids, find out what's going on--if it's ADHD or something else. And many moms are glad we bring it up. I'm glad somebody told me about NeuroPsychs or my son would still be on heavy meds for bipolar, which he doesn't have. However, since I went through the ADHD/bipolar diagnosis, I learned a lot about the disorders, and now I also know a lot about ASD, which my son actually has. Anyone can take what they want from my posts and leave the rest. Doesn't bother me.

Actually mood stabilizers are for bipolar, but many doctors use atypical antipsychotics for aggression. These include Risperdal, Abilify, Geodon, Zyprexa and Seroquel. I have no idea why some doctors call them mood stabilizers. The five first line mood stabilizers are Lithium, Lamictal, Tegretal, Trileptal, and Depakote. They are more effective over the long time. AP's can be useful as PRN's or for the short term, but are not ADHD medications.

MomWI38908.2075810185