11 year old - very MS adjustment - next step?
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Anonymous
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My son is in 6th grade. Bright kid, has been a good, if somewhat lazy,student (not sure if it means anything but has gotten 4s and 5s on PARCC the last 3 years). He's now in public middle school and the adjustment has been really hard. He's fine socially. It's the academics and homework demands and the organization he needs to be successful. He's had two complete emotional breakdowns in the last two weeks about school demands. He talks about how his brain doesn't "work right" and he clearly feels a great deal of anxiety. I regularly witness how he can't seem to focus or concentrate and will constantly seek out distraction. I don't know much about any of this yet (I'm going to research and read all weekend) but without knowing what I'm talking about, I suspect ADD or ADHD or perhaps straight up anxiety. I don't know!
I spoke with his pediatrician earlier (has known him since birth and knows him pretty well) and she wants us to contact Stixrud for an evaluation. During our discussion I told our ped that we are not anxious to medicate our son, so if we can avoid it we'd like to (I wanted her to understand that we aren't wanting to just throw meds at the problem, but really want to understand what the problem is). She agrees. She explained that if he is medicated for ADD, for instance, it would not treat any underlying emotional problem, thus the suggestion of Stixrud, I suppose (which would be a neuropsychologist eval, right?). But we are open to the idea is medication if we feel confident in his diagnosis and demonstrated need for it. My question for all you DCUM SN thread veterans is if going straight to Stixrud for neuropsych is a good route at age 11. Our doc made it seem like "don't waste time." But I'm wondering if we should consider a developmental pediatrician first? I don't even know what the various evaluations are that are involved. Can anyone point me to some reputable online resources where I can educate myself a bit? I'm worried for my son. He seems totally flummoxed and is staring to get sad and I'm not sure how to help him. Thanks. |
Anonymous
| Dang. Title should have read "very difficult MS adjustment". Sorry |
Anonymous
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You need a neuropsych if you really think this is ADHD, inattentive or otherwise. A developmental pediatrician is better suited for children whose issues are more global, or emerged much younger (e.g. birth to 7 or 8).
A neuropsych will help make sure there aren't underlying learning disabilities or anxiety -- which can look a lot like inattentive ADHD. Middle school is where many bright students who have been able to keep things together struggle. Some of them are diagnosed with something, others are just regular kids who need extra support in time management and organization. Stixrud isn't the only option though. I've used 3 firms over the years (not Stixrud) and had the best experience with Mindwell in Chantilly VA. Good luck. |
Anonymous
| I would go for the neuropsych. I agree with the down't waste time approach and you are going to get pretty comprehensive testing this way. You can learn a lot this way and they will try to differentiate between anxiety, attention issues, learning differences, etc/. |
Anonymous
| Yes, developmental pediatrician is not the right person at your child's age. I agree with neuropsych. We went to Stixrud and had a very good experience. |
Anonymous
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Don't waste your time with a dev ped.
We had our son evaluated at Stixrud when he was 10, knowing he already had a tentative ADHD diagnosis given by a dev ped at 6 and an IEP, and it was so illuminating! The report described his severe ADHD, his learning strengths and weaknesses and so many more things than just a straight-up diagnosis. We had IQ scores, with the subcores breakdown: we saw his processing speed was in the single digits, which is incredibly low for a percentile. We saw he scored in the 99th percentiles for verbal comprehension and similar things, which led to a gifted and learning disabled placement for middle school (GT/LD). There was also a dyscalculia and dysgraphia diagnosis, and the psychologist suggested along many other accommodations in her report, that he be allowed the use of a calculator and voice to text software. He has never taken advantage of most of the suggestions, except the extra time on test, but they fact they are there, and have been transferred to his IEP, is security if he does need it someday if/when the load becomes too much. Since he is in a GT/LD program, they have a dedicated resource class with a teacher that helps them organize what they need to do and when. It takes the place of an elective, and is well worth it, so kids like DS can get a head start on their work and get organizational help. Like you, my husband was adamant against meds. The psychologist did not push meds - she wouldn't be the one prescribing them anyway. But the report and test scores were so dire, he was so clearly in need of help, and the teachers at school were all in agreement that he needed *something* (they are not allowed to mention ADHD or meds), that he ended up agreeing to meds. Honestly, we should have medicated him much earlier. Once you have the report in hand, you will feel much more able to come to a decision regarding treatment. If there is both ADHD and anxiety at play, treatment may be a little more complicated, and I strongly encourage you to try child-appropriate meditation and healthy routines first, before using anxiety meds. |
Anonymous
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You should get the neuropsychological exam. I've been to Stixrud and felt they were very good. No need for a developmental pediatrician. You can get medication from a child psychiatrist. The medications for ADHD are safe and effective for most kids. If it's something else, like a learning disability, there are no medications, but you'll want to get your child specialized instruction to overcome the LD. Many children have both ADHD and a learning disability, and a neuropsych will provide that information too.
Here is a link to more information on neuropsychs. http://www.childneurologyfoundation.org/disorders/neuropsychological-assessment-children-adolescents/ |
Anonymous
| I'm grateful to all the PPs for your incredibly helpful and generous comments! Thank you! -OP |
Anonymous
| DD was like your son. It all fell apart in 6th grade. She was in therapy for anxiety and the therapist suggested ADHD based on DD's own description of her challenges in middle school. I was resistant to the ADHD diagnosis but we decided to try a trial of meds while waiting on the neuropsychologist. The meds made a HUGE difference along with a 504. The neuropsychologist confirmed the diagnosis after testing. In retrospect, we should have done medication sooner. |
Anonymous
I meant to add that medication should be prescribed by a child psychiatrist not a pediatrician. It can be tricky to find the right medication and dosage for some kids. |
Anonymous
| Also, and I mean this to educate and not to criticize, don't come on the SN board and say stuff like you don't want to just "throw meds" at your kid. For most of us the decision to medicate was undertaken after much agonizing deliberation and in consultation with experts, and the medication is in conjunction with other interventions. Perhaps you didn't realize it, but your language is loaded with judgment about a topic you are clearly ignorant about. We will help you and share our hard-won wisdom because we've been in your shoes, worried about our kids, so we get it, but you should maybe try not to insult the people whose advice you seek. |
Anonymous
| Understood, PP. thanks for the check. For those of us on the outside and still unknowledgeable about this world of evals and diagnoses, it's scary entering it not knowing what we'll encounter. Or at least it is for me. I admittedly have my back up ready to protect my son from what I fear will be "professionals" who insist that the route must include prescription drugs. I will check myself, keep an open mind and remember that Im not the first mom to agonize over the decision. |
Anonymous
Ditto. A developmental pediatrician isn't a waste of time, but you need to drill down on specific issues. |
Anonymous
Nobody insists on medication for ADHD. All the psychiatrists we've seen are extremely cautious about medicating. |
Anonymous
Thank you. Even knowing that is helpful. -OP |