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Doctor Blake
Doctor Blake, Psychologist
Category: Mental Health
Satisfied Customers: 146
Experience:  Ph.D., Ed.S., NCSP Clinical Psychologist; 15+ years of experience; dual licensure
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My son is six but emotionally and mentally, he a young 6. We

Customer Question

My son is six but emotionally and mentally, he a young 6. We were concerned at one stage that he has Tourette but that was ruled out after an ECG. Yet, he continues to have very short attention span, finds difficulty in following instructions & is easily distracted. It is not unusual for him to forget something he has just learnt an hour ago yet he will recollect a very precise point that you said in a conversation a week.

He is weak in his spelling, reading and maths. His handwriting is atrocious yet he can cut pictures relatively accurately with a pair of scissors.

He is creative at creating things with materials but really does not anything that require some amount of mental work. It is painful to get him to complete mental tasks at any great pace. He is sociable, not destructive, can sit quietly for long journeys but, he has a compulsion to hold/pick-up things: scraps, ice-cream sticks, twigs, leaflets....anything.

Does he have AD (without hyperactivity) & should I be worried?
Submitted: 7 years ago.
Category: Mental Health
Expert:  Doctor Blake replied 7 years ago.

Good morning.


Thanks for your question to JA.


You raise a number of interesting questions about your son. I understand your desire to have a more clear diagnosis, but I think it is important to let you know about the limitations of on-line expert advice. We can provide you with "next steps" to consider from an expert's opinion, but it would be unethical and inappropriate to diagnose over the internet.


That being said, you raise a number of questions which I believe can best be answered through conducting a multifactored or multidisciplinary evaluation. Here in the US, there are two main options to pursue these: (1) is through the local school district, which will examine all areas of a child's functioning - particularly with regard to how this functioning impacts the child's ability to do in school. (2) is through the local children's hospital/medical center. This assessment is typically more diagnostic in focus and will also include the medical opinion of a developmental pediatrician.


In your child's case, I believe option 2 would be a better choice.


Within the multidisciplinary evaluation, a number of questions may need to be addressed. Since you will be a member of the diagnostic team (after all, the experts are expert in diagnostics... but only YOU are an expert on your son), you might want to ask a number of questions:

- What role does Tourettes/tic disorder play in his current functioning?

- What evidence is there of Obsessive Compulsive Disorder or related anxiety disorders?

- What role does language functioning play (Speech/Language Pathologist)?

- How does he function in terms of his sensory/motor development (OT/PT)?


A number of diagnostic questions emerge from you questions including ADHD. However, it is important to note that a youngster (particularly as young as 6) may display a number of different symptoms which can manifest in a variety of ways in different environments. What might look like ADHD one day might look like Tourette's another, OCD another, Asperger's another, Sensory/Motor Integration Disorder another, etc. etc. etc.


In short, in my experience, and just looking at the information provided, we would look at the descriptions you have provided and say, "the child is neurodevelopmentally complex." This is another way of saying that he needs a thorough, multidiciplinary evaluation that will look at all aspects of his growth and development. Having all of these professional opinions will only help in understanding him better.


Thanks. I hope this was helpful.


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