ADHD assessment - Part III
ARRGH, I finally got the time to write out my last observations on my last session with Dr. Y, and THE POWER WENT OUT. Gaaah.
Okay, trying again:
Last night, my mother and I went over a "Retrospective Behaviour Checklist for Parents" together that Dr. Y gave to me to have Mom fill out. This is so she knows if my symptoms have been consistent from childhood.
When Dr. Y and I were going over a similar checklist together, we came up with 7/9 inattentive symptoms that are currently giving me grief, and 2/9 hyper/impulsive symptoms, those two being "talks excessively" and "often feels physically restless." Although it's really only the latter one that's actually a problem sometimes, because I can have a hard time sitting still enough to do work. I mostly let Dr. Y interpret the severity of my H/I symptoms, because that's not at all what I went in there for. I didn't go in trying to present myself as a hyper or impulsive adult, just an inattentive one. I never thought that I'd been anything other than an "absent-minded professor." (As my mother has called me for years.)
I did note at one point to Dr. Y that my social life as a child was utter hell - every damn kid in the school hated my guts. She asked me why that was, and I honestly couldn't tell her. I can't remember my childhood! I did say that I remember that I always seemed to say the wrong thing at the wrong time, and was burned for it. Her interpretation was that this was impulsivity at work, but I didn't agree. I insisted that I was only missing social cues. She was forced to agree that the picture I presented in her office was not impulsive whatsoever - that I was calm and quiet (without being timid) and answered her in a measured way.
My mother has a VERY different story to tell. Her responses to the checklist, and her comments:
RETROSPECTIVE BEHAVIOUR CHECKLIST FOR PARENTS
CHILD Daniel W*********
PARENT Mother (Liza *******)
DATE Nov. 10, 2005
BEHAVIOURS
[Inattentive symptoms]
1. failed to give close attention to detail and/or made careless mistakes in schoolwork, chores, or other activities
VERY OFTEN - OFTEN - SOMETIMES - RARELY
Chores - failed to follow though - didn't 'see' what still needed to be done
2. had difficulty sustaining attention in tasks or other activities
VERY OFTEN - OFTEN - SOMETIMES - RARELY
if the task was uninteresting, Dan found many other things that need to be done 'right now'
[Her comment was that this didn't apply when I was "really, REALLY interested" in something, hence the "sometimes" answer. I explained to her that it wouldn't help to factor in hyperfocus, unless she really felt I was not hyperfocused and focusing "normally." This is why her answers get more indecisive....]
3. did not seem to listen when spoken to directly
VERY OFTEN - OFTEN - SOMETIMES - RARELY
was forever being yelled at as normal tone of voice didn't seem to have an impact. (specifically when being given direction)
4. failed to follow through on instructions, finish schoolwork or tasks, and/or complete activities after starting them
VERY OFTEN - OFTEN - SOMETIMES - RARELY
1/2 finish projects abound
Instructions for tasks had to be given one step at a time or only the 1st one or two would be completed
5. had difficulty organizing tasks and activities
VERY OFTEN/OFTEN - SOMETIMES - RARELY
You should see the bedroom (I have pictures!)
Was unable to organize/clean in any reasonable (methodical) way (still isn't)
[I think that should be an "is" but whatever.]
6. avoided, disliked or was reluctant to engage in tasks that required sustained mental effort or close concentration (such as schoolwork or homework)
VERY OFTEN - OFTEN/SOMETIMES - RARELY
Large projects were a big problem
Dan was unable to organize/focus for that long
[I have somewhat different answers for childhood, because I remember how much I hated school work and how tired I got trying to do it, but my mother points out that she really only personally saw resistance with the biggest things - "dislike" can be hard to see from the outside.]
7. lost things necessary for tasks or activities (e.g. keys, books, school assignments, tools, pencils)
VERY OFTEN/OFTEN - SOMETIMES - RARELY
Yes - agendas, pens, keys, etc.
8. was easily distracted
VERY OFTEN - OFTEN/SOMETIMES - RARELY
less easily distracted from things he was interested in, but at certain times he still had a tendency to wander off - either physically or mentally
[She interpreted "distraction" as (most of the time) getting up and walking off when I was supposed to be working. While I interpret it as, I'm so distracted by every noise in the classroom that I can't even see what's in front of me. So I think this actually belongs under question 2, but whatever.]
9. was forgetful in daily activities
VERY OFTEN/OFTEN - SOMETIMES - RARELY
Yes - forgot homework, lunches, library books, chores, etc., etc.
[Hyperactive/Impulsive symptoms]
1. fidgeted with hands and feet; squirmed in seat
VERY OFTEN - OFTEN - SOMETIMES - RARELY
hair twirling
[I'm not sure why she felt compelled to mention that specifically, but maybe it's because she was constantly cutting huge knots out of my hair from the frantic twirling. My teachers of yesteryear would probably complain about being tripped because I stuck my legs in the aisle while I squirmed.]
2. left seat in classroom or in other situations where remaining seated was expected
VERY OFTEN/OFTEN - SOMETIMES - RARELY
Yes - especially in grades 4-6 when in an 'open' classroom
[I definitely remember that I was the kid who took way too many bathroom breaks, was always sharpening my pencil, and who would sometimes simply walk out of the room and wander the school for no "good" reason. That got worse in 4-6 because I couldn't handle the noise level and intensity of a large 60+-kid classroom, and left in near-meltdown frequently. My mother notes that no matter how many times I was told that I had to "follow procedure" and tell the teachers I was leaving, I didn't take the time to.]
3. appeared physically restless
VERY OFTEN - OFTEN - SOMETIMES - RARELY
not really in a gross motor sense
[No "bouncing off the walls," out-of-control physicality that drove people nuts.]
4. had difficulty engaging in leisure activities quietly
VERY OFTEN - OFTEN - SOMETIMES - RARELY
5. was often "on the go" or acted as if "driven by a motor"
VERY OFTEN - OFTEN - SOMETIMES - RARELY
6. talked excessively
VERY OFTEN - OFTEN - SOMETIMES - RARELY
talked early and hasn't shut up since :)
7. blurted out answers before questions had been completed
VERY OFTEN - OFTEN - SOMETIMES - RARELY
this was an issue until Dan was placed in a school where such behaviour wasn't considered an issue (Grade 4)
[Said "open school." Before that, she says, she got irate phone calls from the school on a regular basis about how she had to teach me some damn manners.]
8. had difficulty waiting his/her turn (was impatient)
VERY OFTEN - OFTEN - SOMETIMES - RARELY
depending on the situation. Dan needed to 'know' his turn would come. If that was in doubt, waiting was a problem.
[i.e., when in a school with desks in rows, I was the kid who would nearly break his arm waving it in the air, but I would wait in my seat to be helped. When in the "open school" where the seats were grouped, I followed the teacher around interrupting her with every student.]
9. interrupted or intruded on others (e.g. butted in conversations or games)
VERY OFTEN - OFTEN - SOMETIMES - RARELY
Yes. adults conversations, other kids.
Okay, so according to her...I was actually quite impulsive. She was very certain of this, even more than she was certain I was a "space cadet" as a child. At least this clears up the mystery of why the other kids didn't like me, and why descriptions of "inattentive type" children never felt right. I didn't quite meet the diagnostic criteria for Combined type as a kid - taking my mother's "lowest" responses (safe side), I come out with 6/9 inattentive, 5/9 hyperactive-impulsive, just sub-threshold. Not being the "bouncing off the walls" kid, you know.
But this makes sense, and feels right. I feel so validated, somehow! I've been trying to come up with 71-bajillion other reasons for why I fling myself around so much when no one's watching, and why I need to excuse myself from dinner tables and so on for secretive "movement breaks." I read that the "only" inattentive types only move around because they are anxious. I've been trying, awkwardly, to make this fit my experience, but it doesn't.
Now I know! Although apparently I've outgrown and internalized my impulsivity to a large degree, something that Dr. Y and I discussed.
She's worried about my self-image, she says. Reason being, there is a large discrepancy between my "public face" and my private self:
Public: Quiet, rarely talking much until I'm very comfortable with people. Jiggling a lot. So concerned about saying the "wrong" thing that I can barely speak in class even when I'm required to. Finding as many excuses as possible to be alone. Utterly drained by other people.
Private: Uncontrollable talking to myself, hours-long monologues. Constant pacing, jiggling, pen-flipping, jumping on couches. Drinking caffeine to be able to sit still. Running up and down the stairs the entire commercial break. Leaving the dinner table to do jumping jacks in private before coming back to eat.
Dr. Y says that she becomes deeply concerned any time she sees this sort of discrepancy in her practice, because it nearly always means her client has a low opinion of themselves, and they are hiding as much of themselves from other people as they can. She says that it will get in the way of my being close to people, because I will be worried they won't like the "bad" parts of me.
I'm not completely sure about that, because I think I do relax around people and be more myself, it just takes a while. And I would not ever want to go back to being the social outcast I was as a child, so I don't think locking in a bit is all bad. I guess I'll see what else she says about that.
Whew! Finally got this whole thing out. If anybody actually reads this, they deserve a damn medal.
Okay, trying again:
Last night, my mother and I went over a "Retrospective Behaviour Checklist for Parents" together that Dr. Y gave to me to have Mom fill out. This is so she knows if my symptoms have been consistent from childhood.
When Dr. Y and I were going over a similar checklist together, we came up with 7/9 inattentive symptoms that are currently giving me grief, and 2/9 hyper/impulsive symptoms, those two being "talks excessively" and "often feels physically restless." Although it's really only the latter one that's actually a problem sometimes, because I can have a hard time sitting still enough to do work. I mostly let Dr. Y interpret the severity of my H/I symptoms, because that's not at all what I went in there for. I didn't go in trying to present myself as a hyper or impulsive adult, just an inattentive one. I never thought that I'd been anything other than an "absent-minded professor." (As my mother has called me for years.)
I did note at one point to Dr. Y that my social life as a child was utter hell - every damn kid in the school hated my guts. She asked me why that was, and I honestly couldn't tell her. I can't remember my childhood! I did say that I remember that I always seemed to say the wrong thing at the wrong time, and was burned for it. Her interpretation was that this was impulsivity at work, but I didn't agree. I insisted that I was only missing social cues. She was forced to agree that the picture I presented in her office was not impulsive whatsoever - that I was calm and quiet (without being timid) and answered her in a measured way.
My mother has a VERY different story to tell. Her responses to the checklist, and her comments:
RETROSPECTIVE BEHAVIOUR CHECKLIST FOR PARENTS
CHILD Daniel W*********
PARENT Mother (Liza *******)
DATE Nov. 10, 2005
BEHAVIOURS
[Inattentive symptoms]
1. failed to give close attention to detail and/or made careless mistakes in schoolwork, chores, or other activities
VERY OFTEN - OFTEN - SOMETIMES - RARELY
Chores - failed to follow though - didn't 'see' what still needed to be done
2. had difficulty sustaining attention in tasks or other activities
VERY OFTEN - OFTEN - SOMETIMES - RARELY
if the task was uninteresting, Dan found many other things that need to be done 'right now'
[Her comment was that this didn't apply when I was "really, REALLY interested" in something, hence the "sometimes" answer. I explained to her that it wouldn't help to factor in hyperfocus, unless she really felt I was not hyperfocused and focusing "normally." This is why her answers get more indecisive....]
3. did not seem to listen when spoken to directly
VERY OFTEN - OFTEN - SOMETIMES - RARELY
was forever being yelled at as normal tone of voice didn't seem to have an impact. (specifically when being given direction)
4. failed to follow through on instructions, finish schoolwork or tasks, and/or complete activities after starting them
VERY OFTEN - OFTEN - SOMETIMES - RARELY
1/2 finish projects abound
Instructions for tasks had to be given one step at a time or only the 1st one or two would be completed
5. had difficulty organizing tasks and activities
VERY OFTEN/OFTEN - SOMETIMES - RARELY
You should see the bedroom (I have pictures!)
Was unable to organize/clean in any reasonable (methodical) way (still isn't)
[I think that should be an "is" but whatever.]
6. avoided, disliked or was reluctant to engage in tasks that required sustained mental effort or close concentration (such as schoolwork or homework)
VERY OFTEN - OFTEN/SOMETIMES - RARELY
Large projects were a big problem
Dan was unable to organize/focus for that long
[I have somewhat different answers for childhood, because I remember how much I hated school work and how tired I got trying to do it, but my mother points out that she really only personally saw resistance with the biggest things - "dislike" can be hard to see from the outside.]
7. lost things necessary for tasks or activities (e.g. keys, books, school assignments, tools, pencils)
VERY OFTEN/OFTEN - SOMETIMES - RARELY
Yes - agendas, pens, keys, etc.
8. was easily distracted
VERY OFTEN - OFTEN/SOMETIMES - RARELY
less easily distracted from things he was interested in, but at certain times he still had a tendency to wander off - either physically or mentally
[She interpreted "distraction" as (most of the time) getting up and walking off when I was supposed to be working. While I interpret it as, I'm so distracted by every noise in the classroom that I can't even see what's in front of me. So I think this actually belongs under question 2, but whatever.]
9. was forgetful in daily activities
VERY OFTEN/OFTEN - SOMETIMES - RARELY
Yes - forgot homework, lunches, library books, chores, etc., etc.
[Hyperactive/Impulsive symptoms]
1. fidgeted with hands and feet; squirmed in seat
VERY OFTEN - OFTEN - SOMETIMES - RARELY
hair twirling
[I'm not sure why she felt compelled to mention that specifically, but maybe it's because she was constantly cutting huge knots out of my hair from the frantic twirling. My teachers of yesteryear would probably complain about being tripped because I stuck my legs in the aisle while I squirmed.]
2. left seat in classroom or in other situations where remaining seated was expected
VERY OFTEN/OFTEN - SOMETIMES - RARELY
Yes - especially in grades 4-6 when in an 'open' classroom
[I definitely remember that I was the kid who took way too many bathroom breaks, was always sharpening my pencil, and who would sometimes simply walk out of the room and wander the school for no "good" reason. That got worse in 4-6 because I couldn't handle the noise level and intensity of a large 60+-kid classroom, and left in near-meltdown frequently. My mother notes that no matter how many times I was told that I had to "follow procedure" and tell the teachers I was leaving, I didn't take the time to.]
3. appeared physically restless
VERY OFTEN - OFTEN - SOMETIMES - RARELY
not really in a gross motor sense
[No "bouncing off the walls," out-of-control physicality that drove people nuts.]
4. had difficulty engaging in leisure activities quietly
VERY OFTEN - OFTEN - SOMETIMES - RARELY
5. was often "on the go" or acted as if "driven by a motor"
VERY OFTEN - OFTEN - SOMETIMES - RARELY
6. talked excessively
VERY OFTEN - OFTEN - SOMETIMES - RARELY
talked early and hasn't shut up since :)
7. blurted out answers before questions had been completed
VERY OFTEN - OFTEN - SOMETIMES - RARELY
this was an issue until Dan was placed in a school where such behaviour wasn't considered an issue (Grade 4)
[Said "open school." Before that, she says, she got irate phone calls from the school on a regular basis about how she had to teach me some damn manners.]
8. had difficulty waiting his/her turn (was impatient)
VERY OFTEN - OFTEN - SOMETIMES - RARELY
depending on the situation. Dan needed to 'know' his turn would come. If that was in doubt, waiting was a problem.
[i.e., when in a school with desks in rows, I was the kid who would nearly break his arm waving it in the air, but I would wait in my seat to be helped. When in the "open school" where the seats were grouped, I followed the teacher around interrupting her with every student.]
9. interrupted or intruded on others (e.g. butted in conversations or games)
VERY OFTEN - OFTEN - SOMETIMES - RARELY
Yes. adults conversations, other kids.
Okay, so according to her...I was actually quite impulsive. She was very certain of this, even more than she was certain I was a "space cadet" as a child. At least this clears up the mystery of why the other kids didn't like me, and why descriptions of "inattentive type" children never felt right. I didn't quite meet the diagnostic criteria for Combined type as a kid - taking my mother's "lowest" responses (safe side), I come out with 6/9 inattentive, 5/9 hyperactive-impulsive, just sub-threshold. Not being the "bouncing off the walls" kid, you know.
But this makes sense, and feels right. I feel so validated, somehow! I've been trying to come up with 71-bajillion other reasons for why I fling myself around so much when no one's watching, and why I need to excuse myself from dinner tables and so on for secretive "movement breaks." I read that the "only" inattentive types only move around because they are anxious. I've been trying, awkwardly, to make this fit my experience, but it doesn't.
Now I know! Although apparently I've outgrown and internalized my impulsivity to a large degree, something that Dr. Y and I discussed.
She's worried about my self-image, she says. Reason being, there is a large discrepancy between my "public face" and my private self:
Public: Quiet, rarely talking much until I'm very comfortable with people. Jiggling a lot. So concerned about saying the "wrong" thing that I can barely speak in class even when I'm required to. Finding as many excuses as possible to be alone. Utterly drained by other people.
Private: Uncontrollable talking to myself, hours-long monologues. Constant pacing, jiggling, pen-flipping, jumping on couches. Drinking caffeine to be able to sit still. Running up and down the stairs the entire commercial break. Leaving the dinner table to do jumping jacks in private before coming back to eat.
Dr. Y says that she becomes deeply concerned any time she sees this sort of discrepancy in her practice, because it nearly always means her client has a low opinion of themselves, and they are hiding as much of themselves from other people as they can. She says that it will get in the way of my being close to people, because I will be worried they won't like the "bad" parts of me.
I'm not completely sure about that, because I think I do relax around people and be more myself, it just takes a while. And I would not ever want to go back to being the social outcast I was as a child, so I don't think locking in a bit is all bad. I guess I'll see what else she says about that.
Whew! Finally got this whole thing out. If anybody actually reads this, they deserve a damn medal.