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April 25, 2006

Behavior

Question from Monteagle, Tennessee, USA:

My son is 11 years old and has had type 1 diabetes for six years. He is now in the fifth grade. Since the third grade, he has had problems focusing, getting work assignments done on time, disorganized, very sloppy hand writing and acts like school is a waste of time. We had him tested for learning disabilities and he tested normal. His I.Q. was high for his age. On the advice of the school, we took him to four different pediatricians to get a diagnosis of ADD. We had him put on Strattera and it did not help. Then, he was put on Adderall, which did not work either. Then, the doctor increased his dose of Adderall and he was literally climbing the walls. The doctor concluded that he did NOT have ADD. Since that time, we have moved to a different area and now he is having the same problems. Could this be related to diabetes? Could it be related to highs or lows? If so, what in the world can we do? My son will probably be in the fifth grade again, even though he is a very bright child.

Answer:

It sounds like ADHD was not the appropriate diagnosis for your son. It is wonderful that his I.Q. is high and that he has no obvious learning disabilities. However, he is clearly struggling in school. There are many subtle learning issues that can cause a child to look disorganized and distracted and fifth grade is about the time when many of these struggles show up. They are typically called “executive function” deficits. The best way to assess for them is to be evaluated by a pediatric neuropsychologist. The testing shouldn’t take terribly long since you already have the IQ and educational testing completed. I’d encourage you to ask your pediatrician and your endocrinologist for referrals to this subspecialty. Also, you can contact your nearest major medical center to see if they have pediatric neuropsychologists on staff. The neuropsychologist can help develop a plan, with your son’s school, to help him be more successful.

JWB