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My gifted nine-year-old, who is an advanced reader, writes and illustrates stories, finds patterns and relationships in math problems, and likes to have theological discussions, has suddenly started having extreme difficulty focusing in school. For example, his teacher often saw him staring off into space for long periods of time during standardized testing and his gifted teacher said that on a recent assignment he wrote only 12 words in one hour without one complete sentence!

He still has all A’s in classes except for Science, in which he has a low D. Lately, the Science assignments have been done on your own during center time while the teacher helps small reading groups. The gifted teacher has mentioned the possibility of ADD since this seems to go beyond occasional daydreaming and reminding him to focus really isn’t cutting it.

Do I ask the school to test him? Do I take him to our pediatrician or ask that his office’s psychologist test our son in some way? Should I go first to an eye doctor since he recently mentioned seeing double at times? Where do we start? I would like to look into this before he goes into fourth grade next year (known to be harder and faster paced).

ADHD is a neurologically-based disorder. Key to making the diagnosis is to establish a chronic and a pervasive history of the behaviors noted. That is, if inattentive, there needs to be evidence of inattention/distractibility since preschool or kindergarten. And, these behaviors should be noted in most situations (home, school, with friends, on vacation , etc). If the problem of focusing “suddenly started” at age nine and seem to be related only to “difficulty focusing in school,” other possibilities need to be considered.

I would start by meeting with his teachers and other school professionals to explore what might be the cause. Ask that someone come to the class and do observations to clarify when this problem is present and to explore for possible causes. Don’t rush to have further studies done until you have more observational data.

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