So Caleb has had all these symptoms of ADD for years, and we were sure he was a difficult case (though not at all a difficult child). He can't think unless he's running, he had no sense of personal space, he had a hard time paying attention, he refused to comply in a classroom setting, he had those bothersome facial tics, etc.
But we've learned a few things about him since he refused to turn his work in at the cyberschool in Colorado.
For one thing, he has a sleep disorder. And it turned out that in 90% of the situations where he had trouble complying with a system or bowing to authority, he hadn't slept enough the night before. The fidgeting, inattentiveness, rebellion, impulsiveness--all are connected to sleep for Caleb. They are there when he's slept enough, but not NEARLY as much. Possibly more along the lines of "he's a kid" rather than "he has ADD".
And then we discovered that he needed glasses, and that, in fact, his vision is worse than mine. No sense of personal space and bad social skills? Nah. He just couldn't see the people he was interacting with unless he got really close, and with no clear view of facial expressions, he couldn't read physical cues at all. The glasses literally fixed this overnight. Facial tics are mostly gone, too--he was screwing up his face trying to get his eyes to focus! And the computer addiction? Faded. He was spending his time staring at a computer screen or the large-screen nintendo TV because he could see those things. Now he spends his day on many varied activities, and plays outside a lot more, and plays more and nicer with his siblings. Being able to see is a big big deal.
Caleb still has to run to think (which is getting harder for him and us now that he's getting so big), and he has an incredibly low boredom tolerance (verbally complaining even in the amount of time it takes the doctor to check his ears for infection) and tends toward micro-fidgeting (not a big deal unless a doctor is trying to look in his eyes or ears and he is jittering around).
Diagnosing a kid with a disorder and medicating them is a hairy thing. While Caleb probably does have ADHD, he would have been overmedicated had we treated him for all the symptoms he had--since so many of them and the severity of them was caused by other disorders.
It reminds me what I learned in my sign language classes--kids with hearing loss are often labeled lazy, rebellious, loud, insensitive, or with a learning or behavior disorder, and treated with medications, when what they really need is help with their hearing.