Expert: Dr Billy Levin - 10/8/2008

Question
Our son is 12 years old and was diagnosed with OCD by a Pediatric Psychiatrist in January of this year. He started taking Zoloft a few months ago and has shown great reduction in anxiety and OCD behaviors. We see the Ped. Psych regularly for meds management.

Our son has shown symptoms of inattention almost his whole life. After his OCD diagnosis we thought maybe OCD was the culprit. However, now that he's doing so much better, his inattentive symptoms have become much more clear and he is not doing well in school. He is not hyper, in fact, he's the opposite. Almost sluggish, he daydreams, misses important instructions and assignments in school, is disorganized and loses papers and things, and can't even focus on what you're saying to him one on one. He seems lost and disconnected to what's going on around him. We are constantly hurrying him. He has no concept of time passage. He has a hard time following conversations and making friends, even though he is smart, funny, friendly, and loveable.

I doubt CAPD because he tested at 9th grade level for reading comprehension and does not seem to struggle with speech or sound differentiation. But he does read and write agonizingly slowly and hardly ever finishes copying work from the board in class. He also rarely finishes tests because he takes so long. These things result in low grades even though he is intelligent and otherwise capable of doing the work. He's good at math but has an F so far. He fritters away most of his evening on homework that should take 30 minutes.

Does this sound like he has ADD without hyperactivity or could OCD still be causing his problems? Can OCD and ADD be treated simultaneously? Or could this simply be immaturity? (He'll be 13 next month but is very small/thin for his age and a bone scan showed at least a 2 year growth delay.)

Thank you for your time.

Answer
It does not sound like ADD, it is ADD. Please do not confuse ADHD with ADD. ADD neglected will often/sometimes result in OCD. The Zoloft is fine but a stimulant should be added. Both conditions can  and certainly should be treated simultanously if needed. ADD is in fact a genetically inherited immaturiry of the left hemishhere of the brain! He probably has a high IQ but is underachieving.I suggest you discuss this with your doctor as a trial on a stimulant is certainly indicated.