My son is 6 years old and is very bright.
Ah, but it depends what the thing IS, somehow. Most ADHD kids can play video/computer games with lovely concentration ;}. My kid has always been able to concentrate on building legos. He actually doesn't require meds often for math homework (really, it's only since he hit 6th/7th grade math that he *ever* needs it; part of it there is the homework takes him > 5 minutes, unlike elementary school!). So, no, it doesn't have to be consistent to be ADHD. And, how do I say this? For my kid, at least, it became more consistent, sort of--as other kids got calmer, more able to focus, you saw the differences for my kid in more areas.
Concentration...it's an effort. I mean, it is for you & me, right? For an ADHD kid, it's a much, much greater effort, sometimes so great they can't do it. Sometimes they can. I haven't read this anywhere, so it may just be my kid, but if he goes to school without meds, he can cope to a certain extent--but he works so hard that he often falls apart when he gets home. Sort of like complete exhaustion, though not the same as having gotten physically exhausted. The meds help him by making it less HARD to concentrate, so his brain can process all the other things, too.
3-step directions: well, when my kid was, say 4, he could be told by his teacher to put X away, wash his hands, and sit at the table. He'd usually get X put away, but wouldn't manage to cross the room to the sink.
A classic one for us is to go upstairs, put on your PJs and brush your teeth (which is a 3-step itself, brush, floss, flouride). He can do it, but it's because of lots of repetition!
My neighbor always says her kid can't be sent down to the basement for 3 things--he'll always come back with just one, maybe two.
Go upstairs, grab your shoes, turn off the light, and bring down your cereal bowl.
That kind of thing--though either of your examples work; the question is, of course, if a non-ADHD kid can reasonably be expected to do whatever it is you are asking.
You can always get an eval--the teacher/parent fill-in-the-bubbles forms are a good screening tool (though, as the Cl says, NOT the final diagnosis! There's too many other things that mimic ADHD!). Sounds like the art teacher did things just right, mentioning the "other things going on", instead of "your kid is". The other thing you might want to ask the teachers--or yourself!--is if you should pursue an evaluation at the SCHOOL. We had most of ours done that way, lots of testing for potential LD, stuff like that. Meant we didn't have to redo those tests for the eventual diagnosis. But, don't delay too much--no matter whether you go Dr/psych or school, it all takes time (months).
I was laughing about the morning-forgets that the rest of you are saying--with my kid, the BEST signal that he's forgotten his meds used to be if we were trying to head out the door for school & we the parents got frustrated because he wasn't getting his stuff on & ready to go. We got good--first response became "did you take your meds??", not "hurry up!!"
I'll let someone else do the talking...http://www.ldonline.org/article/c670/
In this context, Silverman notes that some professionals erroneously assume that a child who demonstrates sustained attention, such as a gifted child engaged in a high-interest activity, cannot have ADHD. It is understandable that an observer might discount the possibility of ADHD because from all appearances the child is so absorbed in a task that other stimuli fade into oblivion. While this state of rapt attention is often described as "flow"), it can also be ascribed to "hyperfocus," which is a similar condition that individuals with ADHD frequently experience.
Activities that is continuously reinforcing and "automatic,” such as video or computer games or reading for pleasure, do not distinguish children who have ADHD from children who do not have ADHD, whereas effortful tasks do. By virtue of their giftedness, the range of tasks that are perceived as “effortless" is broader for gifted children, which is why their ADHD may be less apparent than in children who struggle more obviously and to lesser effect.
Recent work suggests that the gifted child with ADHD is particularly predisposed to exhibit this state of “flow" or "hyperfocus." While this can be a positive aspect of task commitment and a sign of motivation, it becomes a problem when the child is asked to shift from one task to another. Therefore, while cognitively this state can have positive aspects, behaviorally it can also cause problems. Furthermore, ADHD is not characterized by an inability to sustain attention, but rather by the inability to appropriately regulate the application of attention to tasks that are not intrinsically rewarding and/or that require effort. Such tasks are, sadly, characteristic of much of the work that is typically required in school, even in programs for gifted students.
While a misdiagnosis of ADHD is undesirable, diagnostic errors of omission are just as serious and may be even more prevalent among gifted students. This difficulty occurs when a student’s over-reliance on strengths inadvertently obscures the disability. While emphasizing strengths may highlight a student's gifts and talents, it does not eliminate the reality of the condition and can, in fact, lead to a worse predicament in which the student distrusts his or her abilities because of the struggle to maintain them. On the other hand, if a student is allowed to acknowledge and experience the disability, he or she may learn appropriate compensatory or coping skills...
Given the realities of the co-existence of giftedness and ADHD, the question should not be "ADHD or gifted?" but rather “how impaired is this student by his/her ADHD?" Some children are able to compensate in most situations for their ADHD (and neither they nor their parents or teachers may be aware of it); others are seriously handicapped. The single most relevant element that must be considered in evaluating ADHD is the degree of impairment a child experiences as a result of the behaviors.>>
*sigh* I know your pain, LOL.
I have to say, though, that I was the exact same way as a child and teen, and when I left my teens it seems like my ability to focus and stay on task vastly improved. It's like a switch in my brain was flicked to the on (or *more* on) position once I reached adulthood.
A child may HAVE ADHD, but it is not what they ARE. Never tell a child they ARE ADHD.
My DS (dx ADHD/combined type) is amazingly focused (for hours at a time) when he likes what he's doing (generally video games or drawing/making comics or reading his favourite magazine). And he's so good at games that totally confuse me, which is completely incongruous with how he performs when asked to do multi-step tasks.
Yup, you got it, and you are testing for both. Just as an example, my 12 yo, if asked to get a towel from the bathroom might come back with shoes from his bedroom. That's when he's unmedicated.
Medicated, he might be able to bring me a towel or if he forgets what he's going for will call down and ask me to repeat what I wanted. Unmedicated, he'd not even think to ask me to repeat, he'd just bring me the wrong thing. Oh, and I'm not suggesting that medication would or should be the way to go if your DS was dx, but just giving examples.
If you're insurance covers an assessment then I'd recommend it. Either they will dx him and he'll get help with some of the school issues, or they'll say that he's developing normally and you can relax. It's win/win.
You could take him to a Neuropsychologist for an evaluation if you are really that worried. ADHD does have some consistencies, but not always. So, ask your ped for a referral if you like, and have him evaluated, it is a loonnng process, usually a couple of weeks of testing and observations. DO NOT let a ped or other Dr give you a "checklist" to fill out and for teachers to fill out, and then make a diagnosis on that alone.....testing would have to be done
Yes, writing is the hardest for him.
That's a really good suggestion. My DS is 12 yo, and even medicated, can't do that yet.
The daydreaming you are describing is a pretty good description of ADHD-inattentive as it showed up in my kid in 1st grade. Sort of like distraction, but coming from his own head, not from the outside.
But, it's a question of degree: obviously all kids don't just sit down & work continually. It's just not going to happen. ADHD, especially (IMHO!) at the younger ages, it's a question of whether their symptoms come out of the "normal" range--to give a different example, nearly all 5 yr old boys wiggle. Lots. So much that you can't necessarily tell a mild ADHD boy from the others. But a few years later, it is blindingly obvious, because the others developmentally calmed down lots & the ADHD one only a little if at all. Same for concentration...
For my kid, we started meds in the summer between 1st & 2nd. Before meds, we'd ask him to write a sentence. He'd need refocusing every 1-4 words, sometimes needing a reminder about about what he'd planned to write. After meds, he'd simply write the sentence. Writing, for my kid, is hardest--TOO many things to keep track of: what you're writing (the words), the spelling, the handwriting, the puctuation, the spaces between the words, etc. It all came together to make it all really hard.
The thing you can probably check at home for ADHD that's a somewhat reasonable metric is, can he follow a 3-step instruction?