Expert: Dr Billy Levin - 8/25/2008

Question
Hi...I am worried about my almost 6 year old(about to enter kindergarten).  He has extremely poor letter recognition and sound awareness of phonemes (I am a speech pathologist). Despite months of presentation, repetition, drill and practice. His father (my husband) was diagnosed last year with ADHD and is a new person on Adderall.  My son does exhibit sleep apnea via a sleep study, low feratin levels,consistent "kicking" in his sleep, left handedness, severe farsightedness and a lazy eye.  He is also very impatient, easily frustrated and prone to temper tantrums.  The only short term memory problems I notice are (verbal repetition)..ie.. if I tell him to go somewhere and ask someone else a specific question...He asks me to repeat the question to him multiple times and usually fails to remember the question. Yet, he can follow multiple steps in directions but constantly mixes up left and right. Very easily bored unless he has a video game. No language acquisition delays...some mild articulation delays which have developmentally corrected.  No hx of any ear problems. Should I be seeking a dyslexia eval or an ADHD eval at such a young age?  I have also heard there is some improvement of the lazy eye on ADHD meds...any truth to that?  Would really appreciate your advice...Thanks

Answer
You have described, in great professional detail a condition that I am able to recognize without even examining the child. I am certain he has ADHD. If ADHD is a genetically inherited(father) neurological immaturity of the left cerebral hemisphere (auditory verbal sequential) not surprising he will have an auditory imperception and a potential reading problem(phonics). Dyslexia is part of ADHD. If his right brain (visio, spacial temperamental) is thus dominant, these  talents will be obvious and computer games done with the right brain a favourites. Young age? You should have  had him on medical treatment long ago The concept of only starting stimulants after 6 years of age is no longer valid. I could do an internet assessment on him if you would like conformation. Either way you should see a doctor who has experience with ADHD. Good luck!