Peeling Back the Layers: ADHD, SPD, Dysgraphia, Autism
It’s pretty common knowledge that many individuals with ADHD will have co-occurring mental health or developmental conditions (also called comorbid conditions), like oppositional defiance disorder (ODD), sensory processing disorder (SPD), learning disabilities, anxiety, depression, bipolar, tourette’s, and more. The CDC states that as many as 30-60% of children diagnosed with ADHD will have at least one comorbid condition. With that statistic in mind, [more…] parents must be diligent to discover all their child’s weaknesses and struggles, not just attribute all issues to ADHD. While labels are unfortunate, knowledge is power — you can’t treat something that is undefined.
My son, Ricochet, was diagnosed with ADHD shortly after his sixth birthday in 2008. I suspected sensory processing disorder (SPD) as well, but the Behavioral Specialist that originally evaluated him felt it was simply typical ADHD. I knew sensory issues were part of it then, and Ricochet’s first grade teacher and I both knew he had a handwriting disability. No one else was ready to see all that I saw in my son though.
About six months after evaluation, still struggling to get a handle on Ricochet’s issues, the doctor recommended he have an occupational therapy evaluation. That validated my suspicion of SPD. It also showed distinct issues with handwriting. The OT was on board, however the school still was not.
While Ricochet had the most wonderful first grade teacher (I called her Ms. Marvelous in my book, Boy Without Instructions, because she was just that.), the special education department refused to provide special services on the basis of handwriting issues, nor for his ADHD that year.
During his second grade year, I realized Ricochet’s writing issues were more than just the mechanics of handwriting — he was struggling with planning, organization, and descriptiveness in written expression as well. This discovery shocked and overwhelmed me. I really didn’t know how to help him with the process of writing — it comes so naturally for me.
The private OT kept working with Ricochet on handwriting and his teacher and I used graphic organizers and scribed for him to help with the written expression component. He was still incapable of writing down his thoughts on his own. By the middle of fourth grade, his learning disability in writing was undeniable and the school granted him special education placement and services.
With each new year, as we peeled back the layers of the onion that is my kiddo, we would discover more and more layers underneath. In fourth grade, anxiety became a significant issue for Ricochet, and he had a full meltdown in the classroom. That year was so traumatic that we had him repeat fourth grade to have a gentler year and to be closer in maturity to his classmates. He was on or above grade level in all academics so we actually had to beg and fight to have him retained.
Now in fifth grade, a new layer has appeared that, quite frankly, I’m shocked wasn’t one of the outer layers. We are in the process of having Ricochet evaluated for high-functioning autism (what was formerly diagnosed as Asperger’s). His social skills have shown little improvement as he ages and he still can’t read body language and tone of voice at all. He’s still very literal, only seeing black and white — I once mumbled under my breath when Ricochet was five or six, “You’re gonna be the death of me;” and he immediately began to cry, thinking that literally meant he was going to kill me. He is also still very focused on only a few interests and largely inflexible. Many of these things could have been attributed to ADHD early on, but their lack of improvement signals that there may be comorbid high-functioning autism at play as well. We had the parent meeting at TEACCH yesterday and, with our interview and the large package of materials and questionnaires I provided, the autism specialist and physician decided a full autism evaluation is warranted. We should have a definitive answer on whether or not we add HFA to Ricochet’s ever-growing alphabet soup this summer.
Go figure, my kid is one of only 18% of all children diagnosed with ADHD that have three or more comorbid disorders.
What conditions does your child have in addition to ADHD?
My older son has been diagnosed with ADHD, SPD and anxiety. My younger son has been diagnosed with ADD and SPD. He probably has dyslexia, but the therapies are the same, so I haven’t had him diagnosed. He’s been in vision therapy to make his eyes work correctly. He also runs at a verrrryyyy slow processing speed, which drives this ad*H*d mom crazy! At age 12, I still write his thoughts out. By copying my writing, he can concentrate on “pretty” writing, and the words are spelled correctly. Medication stops the ODD traits, but it doesn’t solve everything-thus the years of multiple types of therapies. It has sucked that he’s had to go through all of this, and work harder than his friends, but it IS getting easier!