Neuropsych - no diagnosis

[Anonymous]

Has anyone’s kid ever had a neuropsych for suspected adhd and then been told, your kid doesn’t meet the requirements for a diagnosis? I’d rather a provider be honest with me about my kid than telling me than telling me what they think I or the school wants to hear. In other words, are there just some kids who are annoying, impulsive but don’t meet a threshold for adhd?

[Anonymous]

Yes, there are kids who are annoying and impulsive without ADHD.

[Anonymous]

How old is your kid? We were told he didn’t meet the diagnosis for ADHD when he was in late elementary school but we’re seeing more signs of it as he’s getting older and likely will reevaluate per his doctor’s recommendation. But it’s more inattentive than impulsive in his case.

[Anonymous]

They are definitely not just telling you what they think you want to hear. They might be bad at their job, though. It’s an art.

[Anonymous]

Anonymous wrote:Has anyone’s kid ever had a neuropsych for suspected adhd and then been told, your kid doesn’t meet the requirements for a diagnosis? I’d rather a provider be honest with me about my kid than telling me than telling me what they think I or the school wants to hear. In other words, are there just some kids who are annoying, impulsive but don’t meet a threshold for adhd?

Yes, definitely.

Unfortunately in today’s world most people that go in expecting a diagnosis will get one. You can provide parent input and interviews after the direct testing and get a much less biased result. Tell the test administrator you have some concerns but would like an unbiased opinion so prefer not to provide any additional input until after they have directly evaluated your child. This may take a bit longer because they might not be able to narrow down specific testing until they’ve observed the child but it’s not an impossible request. They’ll probably just start with a developmental assessment and language assessments which provide a lot of great information anyways that you often don’t get if they’re targeting just one diagnosis.

[Anonymous]

Anonymous wrote:How old is your kid? We were told he didn’t meet the diagnosis for ADHD when he was in late elementary school but we’re seeing more signs of it as he’s getting older and likely will reevaluate per his doctor’s recommendation. But it’s more inattentive than impulsive in his case.

We had a similar experience with ASD. DC did not meet the criteria in elementary, although we suspected. Now in high school and still waiting for the formal eval, but have had multiple providers suggest DC will get an ASD diagnosis (and it seems more obvious now).

[Anonymous]

Anonymous wrote:Yes, there are kids who are annoying and impulsive without ADHD.

Yes but OP is specifically asking if any of those kids were NOT diagnosed with anything upon completing a neuropsych.

[Anonymous]

Anonymous wrote:Has anyone’s kid ever had a neuropsych for suspected adhd and then been told, your kid doesn’t meet the requirements for a diagnosis? I’d rather a provider be honest with me about my kid than telling me than telling me what they think I or the school wants to hear. In other words, are there just some kids who are annoying, impulsive but don’t meet a threshold for adhd?

Is your kid bored in school? My kid had a neuropysch at age 4.5 and was dx with ASD (this was not unexpected) and at the time, given a provisional dx of ADHD. Report said to reevaluate for that around age 6-7 Dr did not want to offically dx at that time. So we did a pyschoeducational eval at 7 and kid was not dx with ADHD, but as gifted-they're 2E. The dr said, their teacher literally wrote 'bored in school' on the teacher eval. The report concurred with the ASD dx also.

So, yes, my kid did not get an ADHD dx.

[Anonymous]

Mine got an LD diagnosis. I was told that his teacher and parent surveys didn’t support an ADHD diagnosis but she saw some borderline ADHD traits during the neuropsych. She made it clear he didn’t meet the full criteria but to keep an eye on it. When we went for a reevaluation 2 years later she no longer saw anything suggestive of ADHD at all.

[Anonymous]

Op here. Thank you everyone. This is so interesting. I definitely want an unbiased opinion and am not looking for someone to just check the box and send me on my way with a prescription. My kid is not hyperactive, is attentive in school and does well academically. He is organized and able to complete tasks on his own. However he is chatty, can be impulsive at times and has a low frustration tolerance. It’s hard to know if what he displays is normal 3rd grade boy behavior, or more. Part of me wonders if we’re so quick to diagnose that we don’t give kids a chance to grow up. That being said, I don’t want to do him any disservice and not get the help he needs now.
All that being said, I would like an unbiased opinion. Are there any neuropsych testers you think are better at giving unbiased opinions than others? Any specific tests we should ask for?

[Anonymous]

Our 9th grader didn’t get an official diagnosis when we had them evaluated for suspected inattentive ADHD. We did find out their processing speed (while still in the normal range) was significantly lower than the rest of the scores. The report did say the although it’s not an official diagnosis that this is called sluggish cognitive tempo and we could seek accommodations or medication if we desired. At the exit interview, when we said we were not going to seek medication, the evaluator said she agreed with that. We did get an executive function coach.

For both this evaluation- and evaluations of our other kid with undeniable issues and multiple diagnoses- most my experience evaluators do take into account what the family is hoping to get out of the process.

[Anonymous]

Oh, I wanted to add that the reports always spelled out the evidence, so you can weigh it yourself in deciding appropriate next steps.

[Anonymous]

Yes. My child was first evaluated in 3rd grade. Our concerns were around executive function, attention, and fine and gross motor skills. He was diagnosed with dyspraxia but not ADHD. Two years later, when the academic demands were greater, he was diagnosed with ADHD.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Has anyone’s kid ever had a neuropsych for suspected adhd and then been told, your kid doesn’t meet the requirements for a diagnosis? I’d rather a provider be honest with me about my kid than telling me than telling me what they think I or the school wants to hear. In other words, are there just some kids who are annoying, impulsive but don’t meet a threshold for adhd?

Yes, definitely.

Unfortunately in today’s world most people that go in expecting a diagnosis will get one. You can provide parent input and interviews after the direct testing and get a much less biased result. Tell the test administrator you have some concerns but would like an unbiased opinion so prefer not to provide any additional input until after they have directly evaluated your child. This may take a bit longer because they might not be able to narrow down specific testing until they’ve observed the child but it’s not an impossible request. They’ll probably just start with a developmental assessment and language assessments which provide a lot of great information anyways that you often don’t get if they’re targeting just one diagnosis.

The opposite happened with us. We were so sure it wasn't ADHD that looking back we really skewed those parent reports to "he's totally fine!" Then the objective tests on attention and processing and memory came back sooooo low (4th percentile on one!). It was a jarring wake up call for us.

[Anonymous]

I posted previously about our kid who does have ADHD, but adding that our other kid was evaluated too, and the result was one 'trait' that can be worked on with a speech therapist (pragmatics), but does not meet a diagnosis for anything. A year of therapy targeting that particular item made a huge difference in all the issues we had been seeing, especially socially.