Recommend an neuro eval for teen girl with many symptoms of various diagnoses

[Anonymous]

I really need help. I’m sorry this is so long.

I’m looking for a thorough neuropsych eval for my teen daughter. Diagnosed with ADHD and GAD but there is so much more. Looking for someone that works well specifically with teen girls to differentiate between so many crossovers like ADHD, Autism, CPTSD, BPD, HPD, OCD, and ODD. It seems like every day she can show symptoms of some or all of these at any given time. She also lies a lot. Mainly about things you don’t even need to lie about and that just increases the anxiety and defiance. She has been to the hospital 3 times, never admitted. Can immediately get into calm mode when there. In IOP once and PHP once. DBT skills as well. No suicide attempts. Only one self harm awhile back. Definite explosive episodes that have subsided much more since PHP. No ED but definitely has a sugar addiction when stressed that is bordering emotional eating. There has been talk of diagnosing her with BPD as she gets older (too young to formally diagnose) but I just feel like she needs more now. We have played around with meds and therapists for years. Her psychiatrist is 20min every 6 weeks and is great with changing meds (I research) but honestly doesn’t give two shits about her. How can you in 20min?

I would say within the last two months my daughter has been much more honest and open (we’ve had therapists before but she is just straight up superficial and lies for months, got kicked out of a group therapy for lying) and I feel it’s the right time to get her evaluated again and done thoroughly. She now has a therapist that is more trauma based and it has helped.

It’s like she is finally ready to get the help she needs. She’s exhausted. Says she just can’t have a quiet mind or calmness. She hates lying. She hates performing. She is just so impulsive and doesn’t like herself unless others like her. She is very social, funny, sarcastic and can be a very good friend and empath. She gets pretty good grades, is very smart when she applies herself and is very athletic. But she also has a hard time pausing and reading others. She is a conformist, but can be impulsive and talk too much or want to be the center of attention. Yet she doesn’t like herself. She’ll do something wrong in the moment that will have bigger consequences later. She has hard time maintaining friends and absolutely can not date. She will make a boy her top priority immediately. She struggles with the long school day. She excels in online school so much more (when she was in a program and also virtual dummer school) Adults and friends love her immediately. But she’s a lot sometimes. she can be hard to coach and teach. It’s like she tries to be nice but can be a bit argumentative and manipulative after awhile. It’s very hard to explain. Some teachers adore her. Others struggle with her.

I’m just desperate to get her looked at more thoroughly. Willing to spend the money, especially if I can find someone really good and if possible, can be seen before the summer is over.

Appreciate any input!!!

[Anonymous]

David Black at CAAT. He's incredibly thoughtful and thorough and knows a lot about the different ways autism can present. Call now because he fills up -- you want him, not one of his people.

[Anonymous]

I would give up for now on a diagnosis because if there were a clear one, you would already know. Unless you have some need to know every facet of her cognition, a battery of cognitive tests in a neuropsychology exam is unlikely to be helpful. I would continue to seek out smart and attuned therapists and psychiatrists to help “conceptualize” her and address the symptoms that present with her personality.

[Anonymous]

OP, I recommend you give Stixrud a call. One of the real benefits of a huge practice is that they have a lot of options for providers/evaluators and make some effort to match your kid with someone who they think is the best fit based on your description of symptoms/presentation.

We had a very good experience with them in fall 2025 - kid had previously been dx with GAD and depression but I knew there was a lot more going on (ADHD, autism, and more). I felt like the doctor who led the evaluation really "got" my kid and the report and dx we ended up with was thoughtful and thorough with an eye toward my kid's current and future needs.

[Anonymous]

Anonymous wrote:I would give up for now on a diagnosis because if there were a clear one, you would already know. Unless you have some need to know every facet of her cognition, a battery of cognitive tests in a neuropsychology exam is unlikely to be helpful. I would continue to seek out smart and attuned therapists and psychiatrists to help “conceptualize” her and address the symptoms that present with her personality.

OP here. That is what we have been doing, but it’s really hard to find the right medications. We have tried SSRI’s, SRNI’s, stimulants, non stimulants, and even a mood stabilizer. I forgot to mention she also is diagnosed with PMDD. It’s a lot.

And at this point with her being older and more in tune with her symptoms and looking back and recognizing past behaviors and trauma, I feel like this is the right time. She used to be in denial, but now she is interested in a potential clearer path. We both know this might not mean definitive diagnoses (it’s hard to diagnose teens) but it’s something she wants now.

[Anonymous]

Anonymous wrote:David Black at CAAT. He's incredibly thoughtful and thorough and knows a lot about the different ways autism can present. Call now because he fills up -- you want him, not one of his people.

Thank you so much but I just realized she probably wouldn’t do well with a straight man, due to past issues and her just being a teen girl. I would be fine with anyone, but for her it probably need to be a female for a honest connection.

[Anonymous]

Anonymous wrote:

Anonymous wrote:David Black at CAAT. He's incredibly thoughtful and thorough and knows a lot about the different ways autism can present. Call now because he fills up -- you want him, not one of his people.

Thank you so much but I just realized she probably wouldn’t do well with a straight man, due to past issues and her just being a teen girl. I would be fine with anyone, but for her it probably need to be a female for a honest connection.

Donna Henderson

[Anonymous]

Anonymous wrote:I would give up for now on a diagnosis because if there were a clear one, you would already know. Unless you have some need to know every facet of her cognition, a battery of cognitive tests in a neuropsychology exam is unlikely to be helpful. I would continue to seek out smart and attuned therapists and psychiatrists to help “conceptualize” her and address the symptoms that present with her personality.

You need to stop. If a neuropsych didn’t work for you I am sorry, but you should put things in terms of I statements instead of saying they should already have a diagnosis already! You realize how incredibly insensitive and out of touch that is?

Are you a troll? Why are you out to dissuade anyone from getting a neuropsych? It’s bizarre

[Anonymous]

Anonymous wrote:I would give up for now on a diagnosis because if there were a clear one, you would already know. Unless you have some need to know every facet of her cognition, a battery of cognitive tests in a neuropsychology exam is unlikely to be helpful. I would continue to seek out smart and attuned therapists and psychiatrists to help “conceptualize” her and address the symptoms that present with her personality.

I agree with this and I am usually a big proponent of neuropsych exams. It sounds like she absolutely needs to keep working with a therapist and stay medicated. I have a AuADHD teen and based on your description, I am not really seeing autism. Of course, she obviously ADHD and all the signs are there (based on your description). It does sound a bit like borderline, but it’s true - she’s too young to put that label on her. The DBT was a good idea regardless since she clearly needs help with regulating.

Good luck to you. Keep the faith that maturity will help her improve. She’s likely delayed in maturity by 2-3 years and that makes it hard to navigate life, especially with a moderate to severe case of ADHD.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I would give up for now on a diagnosis because if there were a clear one, you would already know. Unless you have some need to know every facet of her cognition, a battery of cognitive tests in a neuropsychology exam is unlikely to be helpful. I would continue to seek out smart and attuned therapists and psychiatrists to help “conceptualize” her and address the symptoms that present with her personality.

You need to stop. If a neuropsych didn’t work for you I am sorry, but you should put things in terms of I statements instead of saying they should already have a diagnosis already! You realize how incredibly insensitive and out of touch that is?

Are you a troll? Why are you out to dissuade anyone from getting a neuropsych? It’s bizarre

Take it easy, lady. I seconded this persons post. I always recommend neuropsych evaluations but see the wisdom here. I have a girl the same age as OP who is AuADHD. We worried about bipolar at the time of diagnosis. I also have another teen female family member with complex mental health issues such as attachment disorder, depression, school refusal, and autism. Now give us your credentials since you are coming so hard at people who have literally BTDT.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I would give up for now on a diagnosis because if there were a clear one, you would already know. Unless you have some need to know every facet of her cognition, a battery of cognitive tests in a neuropsychology exam is unlikely to be helpful. I would continue to seek out smart and attuned therapists and psychiatrists to help “conceptualize” her and address the symptoms that present with her personality.

I agree with this and I am usually a big proponent of neuropsych exams. It sounds like she absolutely needs to keep working with a therapist and stay medicated. I have a AuADHD teen and based on your description, I am not really seeing autism. Of course, she obviously ADHD and all the signs are there (based on your description). It does sound a bit like borderline, but it’s true - she’s too young to put that label on her. The DBT was a good idea regardless since she clearly needs help with regulating.

Good luck to you. Keep the faith that maturity will help her improve. She’s likely delayed in maturity by 2-3 years and that makes it hard to navigate life, especially with a moderate to severe case of ADHD.

She can stay medicated and still work with a therapist. There is no reason to not get a neuropsych evaluation

[Anonymous]

Anonymous wrote:OP, I recommend you give Stixrud a call. One of the real benefits of a huge practice is that they have a lot of options for providers/evaluators and make some effort to match your kid with someone who they think is the best fit based on your description of symptoms/presentation.

We had a very good experience with them in fall 2025 - kid had previously been dx with GAD and depression but I knew there was a lot more going on (ADHD, autism, and more). I felt like the doctor who led the evaluation really "got" my kid and the report and dx we ended up with was thoughtful and thorough with an eye toward my kid's current and future needs.

+1

We used Dr. Yael Rothman at Stixrud and were very happy with her. I believe I heard about her on dcum.

[Anonymous]

Anonymous wrote:OP, I recommend you give Stixrud a call. One of the real benefits of a huge practice is that they have a lot of options for providers/evaluators and make some effort to match your kid with someone who they think is the best fit based on your description of symptoms/presentation.

We had a very good experience with them in fall 2025 - kid had previously been dx with GAD and depression but I knew there was a lot more going on (ADHD, autism, and more). I felt like the doctor who led the evaluation really "got" my kid and the report and dx we ended up with was thoughtful and thorough with an eye toward my kid's current and future needs.

Does a large place like that have all doctors doing the evaluation. I keep hearing some places don’t.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, I recommend you give Stixrud a call. One of the real benefits of a huge practice is that they have a lot of options for providers/evaluators and make some effort to match your kid with someone who they think is the best fit based on your description of symptoms/presentation.

We had a very good experience with them in fall 2025 - kid had previously been dx with GAD and depression but I knew there was a lot more going on (ADHD, autism, and more). I felt like the doctor who led the evaluation really "got" my kid and the report and dx we ended up with was thoughtful and thorough with an eye toward my kid's current and future needs.

Does a large place like that have all doctors doing the evaluation. I keep hearing some places don’t.

You book with the person who does the evaluation. At CAAT, the doctor we booked absolutely did the testing and wrote the report.

[Anonymous]

You mention a trauma history. Without compromising her privacy, what are the parameters of it? Age, duration, recency, intensity, other people involved?

What is her ACE score?

Seconding the poster who says that you may never get one unifying diagnosis. Particularly with severe developmental trauma, things can be wonky for a lifetime. They can get MUCH more stable and livable, regardless. Good wishes to you both.