KKI vs Pascualvaca for neuropsych eval

[Anonymous]

My 8 yo w suspected inattentive ADHD got a call from KKI for an appt. He is clearly inattentive, also very bright, his executive function in academic, home, and social settings is awful. Goal of neuropsych is to sort out if there is any autism, as well as eval for learning disabilities and anxiety. Writing is a struggle for him, and learning to read was too, though he is on grade level now. He has a 504 but he's on grade level without behavioral issues and school said did not qualify for iep based on info so far.

An eval would likely be substantially covered by our insurance at KKI as we've met our deductible (though some educational testing would be out of pocket as I believe it is not covered by our plan). At Pascualvaca (recommended by peds), it would be ~6k with the autism testing, and we will likely not get any of that reimbursed due to high deductible plan with a high out of network deductible.

We have the family capacity to pay for out of pocket testing, but it would absolutely take away from some other savings pot (retirement, college, vacation, etc) and it's not a small sum.

Is it *really* worth it to go private?
We are in DC -- other recommendations for testing locations that are some thousand less than that, willing to travel locally.

[Anonymous]

I'd start with KKI as its covered by your insurance and if you want a second opinion as you don't agree with the results, go with the private one. Its pure luck with the provider you get and their skill level in understanding your child. You are better off spending the $6K on tutoring or other supports your child needs.

[Anonymous]

do NOT spend your vacation money on this. KKI is fine.

[Anonymous]

Anonymous wrote:do NOT spend your vacation money on this. KKI is fine.

Strongly disagree. KKI is backed up for years. First there will be an intake appt with staff; then after months an intake evaluation; then a very long wait until the actual testing. In our case it was a three year wait so we went with Daisy. Read posts like these: https://www.dcurbanmom.com/jforum/posts/list/15/1166750.page. Then post in the soecial needs thread asking for updated news about the wait. The call KKI and ask (the person who answers the phone win't know or will punt). There is a reason why KKI is less expensive, and why a multiyear wait This is about your child and very important.

[Anonymous]

What PP said is why we went with Daisy. The $$$ was worth it due to the speed. I'm glad we did it. We needed the nueropysch to sort things out and it ultimately would have cost more to have waited for KKI (even if was initially out first choice).

[Anonymous]

Anonymous wrote:My 8 yo w suspected inattentive ADHD got a call from KKI for an appt. He is clearly inattentive, also very bright, his executive function in academic, home, and social settings is awful. Goal of neuropsych is to sort out if there is any autism, as well as eval for learning disabilities and anxiety. Writing is a struggle for him, and learning to read was too, though he is on grade level now. He has a 504 but he's on grade level without behavioral issues and school said did not qualify for iep based on info so far.

An eval would likely be substantially covered by our insurance at KKI as we've met our deductible (though some educational testing would be out of pocket as I believe it is not covered by our plan). At Pascualvaca (recommended by peds), it would be ~6k with the autism testing, and we will likely not get any of that reimbursed due to high deductible plan with a high out of network deductible.

We have the family capacity to pay for out of pocket testing, but it would absolutely take away from some other savings pot (retirement, college, vacation, etc) and it's not a small sum.

Is it *really* worth it to go private?
We are in DC -- other recommendations for testing locations that are some thousand less than that, willing to travel locally.

Our family had phenomenal results with KKI! Really great experience.

Better to save money for possible treatment needed afterthought diagnosis!

[Anonymous]

Anonymous wrote:

Anonymous wrote:do NOT spend your vacation money on this. KKI is fine.

Strongly disagree. KKI is backed up for years. First there will be an intake appt with staff; then after months an intake evaluation; then a very long wait until the actual testing. In our case it was a three year wait so we went with Daisy. Read posts like these: https://www.dcurbanmom.com/jforum/posts/list/15/1166750.page. Then post in the soecial needs thread asking for updated news about the wait. The call KKI and ask (the person who answers the phone win't know or will punt). There is a reason why KKI is less expensive, and why a multiyear wait This is about your child and very important.

KKI already called them off the list. There’s zero reason to pay $6 for a “neuropsych.” that’s abusive.

[Anonymous]

I'd definitely stick with KKI, especially if your child is doing well enough in school not to flag for an IEP.

[Anonymous]

Anonymous wrote:I'd definitely stick with KKI, especially if your child is doing well enough in school not to flag for an IEP.

+100. Save the money for a writing tutor.

[Anonymous]

We went with Pascualvaca and are extremely satisfied. They uncovered several learning disabilities that we had a hunch might be mixed in with child's ADHD, and they also were very thorough with all the testing and results, and ruled out some things that we were not sure about. We got several recommendations for child as well, including IEP accommodations. We had been through this testing once before and by far Pascualvaca was much more thorough and in depth. The testing took place over the course of 2 weeks and results were back within a month or less. (I cannot remember exactly how long but it was 3 weeks to a month for the full report and meeting to walk through it with the tester.)

That being said, I have no experience with KKI so I cannot compare.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:do NOT spend your vacation money on this. KKI is fine.

Strongly disagree. KKI is backed up for years. First there will be an intake appt with staff; then after months an intake evaluation; then a very long wait until the actual testing. In our case it was a three year wait so we went with Daisy. Read posts like these: https://www.dcurbanmom.com/jforum/posts/list/15/1166750.page. Then post in the soecial needs thread asking for updated news about the wait. The call KKI and ask (the person who answers the phone win't know or will punt). There is a reason why KKI is less expensive, and why a multiyear wait This is about your child and very important.

KKI already called them off the list. There’s zero reason to pay $6 for a “neuropsych.” that’s abusive.

Are you on the list? Did tgey tell you how long of a wait?

[Anonymous]

I would go with the free testing. We've had lots of different testing done over the years from private, expensive to the insurance-covered clinical setting like KKI - it's all about the same. Save your money for other things!

[Anonymous]

My opinion is that the 6k neuropsychologicals are overkill in 90 percent of cases. If yiu give a child enough tests, you’ll find a weakness but that doesn’t always manifest itself in anything meaningful to support the child.

[Anonymous]

OP here. Thank you for weighing in, everyone. My kid isn't really struggling badly *yet* but definitely having more trouble in 3rd this year than earlier. His social struggles are variable and seem more related to his inability to keep track of what is going on around him attentionally, than rigidity or trouble reading social cues, but I do think the autism eval makes sense. I, and his teachers, have some concern about possible dyslexia or other nonverbal learning disability.

We got on WLs at KKI and Children's a while ago, and got a call from KKI (a cancellation i think) right when I'd started to look into private evals after our first meeting with his teachers about his performance this year.

I appreciate the input (feel free to send any more) and will likely stick with KKI if I can confirm with my insurance that it will be substantially covered. (For some reason, this is surprisingly hard to get a straight answer on!) What I'm struggling with is that I might somehow end up paying thousands out of pocket at KKI (though likely less than private) and ending up with less thorough, complete, or correct information.

I agree that I'd rather save the $ for tutoring or other therapies that might be helpful unless there will be a substantial difference in the reports.

If the report doesn't seem to ring true, or he continues to struggle, we can seek out a private eval in the future.

[Anonymous]

We have been at both places, and had good experiences at both (Dr. Rao at Pascaulvaca trained at KKI). I would def stick with KKI for now--8 is really young, and a lot may change as your child matures. Our insurance covered all but the educational testing, which was maybe $250? There will be a time for a more nuanced eval when your child is older, and I would consider Pascaulvaca then. We felt it was worth the $$.

One note though: KKI may not automatically do the Autism testing unless you were up front about that. We did the neuropsych at age 7 at KKI and didn't specify when scheduling re: ASD concerns. At the time, the Autism testing was done by another practitioner (I think an SLP), not the PsyD, so it would have to be scheduled separately. Not sure if it's still like that.