Need private school ASAP for ADHD 5yo — eloping, dysregulated, needs active learning

[Anonymous]

I would think Deiner would be a great fit. Call them and see if they would take a mid-year admit.

[Anonymous]

[quote=Anonymous]

The ADOS you mention is typically given when there are indications of autism or to rule out autism, and thus it is not always used in the ADHD diagnosis process.

While a neuropsychological is not necessary for an ADHD diagnosis, it is definitely more than adequate for an ADHD diagnosis and it is conducted by a "clinician". You can get an ADHD diagnosis from a primary care doctor, a pediatrician, or a psychiatrist, who will usually observe clinically and ask for some forms like the Connors or Vanderbilt to be completed by parent, child and teacher, the results of which are used in the diagnostic process. This diagnostic visit with a health professional is "adequate" for diagnosing ADHD.

However, many kids with ADHD also have 1 or more co-morbid disorders - autism, anxiety, depression, or learning disabilities (dyslexia, reading disorder NOS, coordination disorders, language processing disorders, or dyscalculia). That is why many parents seek a full neuropsychological assessment. The neuropsychological typically includes IQ/ability testing, achievement testing, and computer or paper questionnaires by parent/teacher/child to assess executive function (like the BRIEF), mood, and other characteristics. Computerized testing of attention via the TOVA, IVA, D-KEFS is often also included, as well as other tests like the Tower of London (executive function/planning), WRAML3 (memory), Rapid Automatized Naming, Beery Visual Motor Integration, Ray-Osterreith and so many more.

Most of these tests administered by a psychologist or neuropyschologist are normed and standardized tests, both of which are very helpful test qualities for diagnosis as well as for the legal processes under disability law; however, a pediatrician can still diagnose ADHD with questionnaires like Connors or Vanderbilt, which are standardized and based on norm-referenced data.

The "clinical assessment" is usually done by the psychologist who meets with the parents, and observes the child during testing and/or in a separate interview. The neuropsychologist, who is a "clinician," selects from among many testing instruments to decide what is appropriate for each particular child. Thus, not every child will get the same battery of tests.

Of course, even where a child is being assessed by a psychologist, the child's pediatrician should also examine the child to rule out physical causes of inattention like - thyroid or parathyroid problems, sleep issues, anemia, other nutrients, eyesight, etc. As well as running blood work (liver and kidney function) which are often required before starting medication.

Parents have to make a lot of complicated decisions about how to spend their time and money to get a diagnosis and support for a child in need. I am not sure why PPs keep criticizing each other's ways of pursuing diagnosis for their child, except where there is misinformation being presented. There are a range of options from school-based assessment to pediatrician to full blown neuropsychological and each child and family will have different needs and resources.

For more information on diagnosis, see [url]https://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-what-you-need-to-know
[/url][/quote]

+1 thank you

[Anonymous]

Can you guys stop replying to posts with bizarre formatting , my own ADHD brain can’t tolerate this haha

[Anonymous]

Anonymous wrote:I would think Deiner would be a great fit. Call them and see if they would take a mid-year admit.

They would not take a child that elopes and hits teachers. Or is aggressive. Do you have any experience with the school?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I haven’t read the whole thread but I’ll add a few things. When my son started K he went from a very structured prek daycare where he’d been for years and through Covid and he had a terrible time in K at first. He was undiagnosed and would elope, have major meltdowns, was sent home from school several times for aggressive/violent behavior, had to be restrained sometimes, and it was generally hell for all of us. We got him in by a miracle for a neuropsych assessment in Dec/ January and he was diagnosed by February with Autism, ADHD. The level of services with the autism diagnosis helped immediately. He’s been on meds with a monthly ped psychiatrist since then. We begged and pleaded with the school to let him repeat K. He has a summer birthday and needed the time. We were able to get the psychiatrist and neuropsychologist write letters recommending repeating K. We were exploring how to have him repeat K privately if needed. The school agreed and it was the best decision. We got him in ABA 3x a week which really helped with the behavior regulation. We spent a lot of time collaborating between the school BCBA (behavior specialist), ABA BCBA and the psychiatrist. My son is in 3rd now and it’s not a picnic but every year gets better. He’s doing well in school (still have challenges with aggression, disruptive behavior and occasional elopement) and has remained mainstreamed.

My advice. Do not delay on a neuropsych evaluation. I know so many parents delay this. Get it now. Get the info. My insurance covered it and I’ve done it 3x now (my daughter has had one twice). ADHD is often comorbid with something else. Find out the something else. Don’t delay on meds. My child unmedicated is a completely different and farrrrr more challenging kid than medicated.

Sure you can bounce around to another school but you will just start over again with a new team and cause more disruption to your kid. I would get to the root of the issues and then deal with those. Partner with the people who are helping your kid day in and day out.

Just dropping a note here to say that my similar kid got an autism diagnosis from a psychologist at an autism clinic covered by insurance - there was no “neuropsych” needed. And this was after we already got a very comprehensive IEP under the “developmental delay” label due to motor skills and behavioral issues based on the school testing and my advocacy.

I just think it is really important for parents to be informed consumers. Anyone trying to say you need to run to spend thousands on a “full neuropsych” is misinformed.

It really depends on the child. Some children with higher support needs can be diagnosed very quickly. Children with lower support needs often do need a more thorough evaluation. My kid may seem NT to many, loves to please other people and does great in structured environments, but really struggles with the intricacies of social communication. She needed someone to spend time reviewing her history, getting teacher and therapist input, getting input from us (parents) and testing including the ADOS.

For a complex child with a potential history of trauma I would absolutely want a thorough evaluation and that takes time, which costs money. It could be you can find a place that takes insurance to cover this, but people here have asked this many times and the answers are the same 2.plscws with long wait lists.

Sure but where you are incorrect is that an extensive battery of standardized cognitive tests is actually what leads to better diagnosis. For a complex child, a clinical evaluation and observation are likely more important. At the end of the day though treatment is more important and no family should be opting to pay Stixrud or CAAT $8k instead of getting immediate behavioral therapy.

Strongly disagree on so many levels. First of all we paid less than half of that at CAAT for a 5 year old because at that age the testing takes less time. We also go reimbursed by insurance for most of the cost.

Second the diagnosis has been transformative for us as parents and we have no doubt it will help our child immensely when she is old enough to understand what it means. We were already doing the right therapies but would definitely have stopped had we not known about the diagnosis because our child.had improved so much. Now we know these are ongoing supports she needs.

The cognitive tests were helpful because we needed to fully understand her strengths and challenges and the school was not going to evaluate in her case.

A “neuropsych” is a battery of standardized tests administered by a neuropsychologist generally focusing on IQ. To say you need a “neuropsych” for diagnosis is nonsensical.

Np and no dog in this fight, but agree I don’t think a neuropsych needs to be part of a standard diagnosis process.

We used to live in dc, which is why I know this forum, and I’ve gotten a lot of good advice here over the years. We moved away and I stayed on this forum. Ds’s problems continued to get worse in k and beyond; he already had a adhd diagnosis from KKi but I was trying to figure out what else was going on, if anything. This site was completely doubled down on him needed a neuropsych. But here’s the funny thing: I had also obv been doing tons of other research for years about sns, on lots of other online resources - articles, providers webpages, forums, I had read a lot. But I had literally never seen another person online ever mention a neuropsych. Ever. We had a psychiatrist for ds meds at the time, and I asked her about doing one - she certainly hadn’t brought it up. And we had a pretty good relationship with her by this time, so she was like that’s fine but kind of weird, and she sent us off the closest person - who was about 1.5 hours away from us. And we live in a pretty moderately sized metro area with a ton of medical resources. Again, it just seems like doing neuropsychs is not at all a standard part of the process, but really is a self perpetuated thing on this forum.

FWIW we did one and I neither found the results super reliable (there wasn’t any magic to it, the doctor was just doing a lot of the tests that we’d already had done piecemeal by other providers - adhd, asd, iq, social pragmatic testing etc), and the output was not super useable, it was a lengthy wordy report that didn’t seem highly personalized to anyone who had already read a lot about adhd and asd. I guess the most helpful thing for me was that it told me that there isn’t a black white diagnosis for mental health stuff - in other words, even the most super star diagnosticians were just using the same crappy questionnaires that every other doctor is applying,

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I haven’t read the whole thread but I’ll add a few things. When my son started K he went from a very structured prek daycare where he’d been for years and through Covid and he had a terrible time in K at first. He was undiagnosed and would elope, have major meltdowns, was sent home from school several times for aggressive/violent behavior, had to be restrained sometimes, and it was generally hell for all of us. We got him in by a miracle for a neuropsych assessment in Dec/ January and he was diagnosed by February with Autism, ADHD. The level of services with the autism diagnosis helped immediately. He’s been on meds with a monthly ped psychiatrist since then. We begged and pleaded with the school to let him repeat K. He has a summer birthday and needed the time. We were able to get the psychiatrist and neuropsychologist write letters recommending repeating K. We were exploring how to have him repeat K privately if needed. The school agreed and it was the best decision. We got him in ABA 3x a week which really helped with the behavior regulation. We spent a lot of time collaborating between the school BCBA (behavior specialist), ABA BCBA and the psychiatrist. My son is in 3rd now and it’s not a picnic but every year gets better. He’s doing well in school (still have challenges with aggression, disruptive behavior and occasional elopement) and has remained mainstreamed.

My advice. Do not delay on a neuropsych evaluation. I know so many parents delay this. Get it now. Get the info. My insurance covered it and I’ve done it 3x now (my daughter has had one twice). ADHD is often comorbid with something else. Find out the something else. Don’t delay on meds. My child unmedicated is a completely different and farrrrr more challenging kid than medicated.

Sure you can bounce around to another school but you will just start over again with a new team and cause more disruption to your kid. I would get to the root of the issues and then deal with those. Partner with the people who are helping your kid day in and day out.

Just dropping a note here to say that my similar kid got an autism diagnosis from a psychologist at an autism clinic covered by insurance - there was no “neuropsych” needed. And this was after we already got a very comprehensive IEP under the “developmental delay” label due to motor skills and behavioral issues based on the school testing and my advocacy.

I just think it is really important for parents to be informed consumers. Anyone trying to say you need to run to spend thousands on a “full neuropsych” is misinformed.

It really depends on the child. Some children with higher support needs can be diagnosed very quickly. Children with lower support needs often do need a more thorough evaluation. My kid may seem NT to many, loves to please other people and does great in structured environments, but really struggles with the intricacies of social communication. She needed someone to spend time reviewing her history, getting teacher and therapist input, getting input from us (parents) and testing including the ADOS.

For a complex child with a potential history of trauma I would absolutely want a thorough evaluation and that takes time, which costs money. It could be you can find a place that takes insurance to cover this, but people here have asked this many times and the answers are the same 2.plscws with long wait lists.

Sure but where you are incorrect is that an extensive battery of standardized cognitive tests is actually what leads to better diagnosis. For a complex child, a clinical evaluation and observation are likely more important. At the end of the day though treatment is more important and no family should be opting to pay Stixrud or CAAT $8k instead of getting immediate behavioral therapy.

Strongly disagree on so many levels. First of all we paid less than half of that at CAAT for a 5 year old because at that age the testing takes less time. We also go reimbursed by insurance for most of the cost.

Second the diagnosis has been transformative for us as parents and we have no doubt it will help our child immensely when she is old enough to understand what it means. We were already doing the right therapies but would definitely have stopped had we not known about the diagnosis because our child.had improved so much. Now we know these are ongoing supports she needs.

The cognitive tests were helpful because we needed to fully understand her strengths and challenges and the school was not going to evaluate in her case.

A “neuropsych” is a battery of standardized tests administered by a neuropsychologist generally focusing on IQ. To say you need a “neuropsych” for diagnosis is nonsensical.

Poppycock.

[Anonymous]

Anonymous wrote:

Anonymous wrote: I agree with PP, get this child a full neuropysch. Find out exactly what is going on. Delaying isn't going to help any. This child is 5, so by the time it occurs the kid will be close to or already 6, old enough to dx ADHD and other things.

OP, in the meanwhile, OT can be really helpful with self regulation. Not saying it's a cure all, but it can help and kids often enjoy it (dd thought it was fun!). It's something to do while you figure out what's going on and where he's going to go to school.

+1 also having a provider that sees your child regularly can help with the evaluation. Our evaluator found that speaking with our OT was extremely helpful.

Don’t waste your time with OT, this kid has serious issues.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote: I agree with PP, get this child a full neuropysch. Find out exactly what is going on. Delaying isn't going to help any. This child is 5, so by the time it occurs the kid will be close to or already 6, old enough to dx ADHD and other things.

OP, in the meanwhile, OT can be really helpful with self regulation. Not saying it's a cure all, but it can help and kids often enjoy it (dd thought it was fun!). It's something to do while you figure out what's going on and where he's going to go to school.

+1 also having a provider that sees your child regularly can help with the evaluation. Our evaluator found that speaking with our OT was extremely helpful.

Don’t waste your time with OT, this kid has serious issues.

OK, ODD

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote: I agree with PP, get this child a full neuropysch. Find out exactly what is going on. Delaying isn't going to help any. This child is 5, so by the time it occurs the kid will be close to or already 6, old enough to dx ADHD and other things.

OP, in the meanwhile, OT can be really helpful with self regulation. Not saying it's a cure all, but it can help and kids often enjoy it (dd thought it was fun!). It's something to do while you figure out what's going on and where he's going to go to school.

+1 also having a provider that sees your child regularly can help with the evaluation. Our evaluator found that speaking with our OT was extremely helpful.

Don’t waste your time with OT, this kid has serious issues.

Agree with this.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My kid's private school would only grant accomodations if we submitted a neuropsych evaluation.

Do you mean an ADHD diagnosis?

No, I mean exactly what I just said. My child’s private school would only grant accommodations for their learning disability if a neuropsych eval was submitted. We tried submitting an abbreviated form from the psychologist because the neuropsych contained private information. They would not accept it.

I do not actually think this is legal - to accept only a neuropsych - but I have seen Sidwell do it. Parents have generally invested too much time and money to challenge them, plus they worry about getting kicked out.

There is nothing in disability law that mandates getting a diagnosis or certain set of tests from a certain type of provider in order to “qualify” for disability accommodations.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My kid's private school would only grant accomodations if we submitted a neuropsych evaluation.

Do you mean an ADHD diagnosis?

No, I mean exactly what I just said. My child’s private school would only grant accommodations for their learning disability if a neuropsych eval was submitted. We tried submitting an abbreviated form from the psychologist because the neuropsych contained private information. They would not accept it.

I do not actually think this is legal - to accept only a neuropsych - but I have seen Sidwell do it. Parents have generally invested too much time and money to challenge them, plus they worry about getting kicked out.

There is nothing in disability law that mandates getting a diagnosis or certain set of tests from a certain type of provider in order to “qualify” for disability accommodations.

To the extent that there are Operation Varsity Blues-type people out there trying to game the system for their kids, I would imagine schools like Sidwell are probably ground zero for higher concentrations of this kind of behavior and that they could probably tell stories that would have all our jaws on the ground. Honestly, I kind of get why they mandate this.

[Anonymous]

I guarantee this dad makes every excuse as to why the child assaulted the teacher- it’s never the child’s fault. Even if the school had the resources to do everything right, 100% of the time, parents like you still won’t enforce consequences at home and the cycle continues.

[Anonymous]

Anonymous wrote:I guarantee this dad makes every excuse as to why the child assaulted the teacher- it’s never the child’s fault. Even if the school had the resources to do everything right, 100% of the time, parents like you still won’t enforce consequences at home and the cycle continues.

This is so unnecessary. Don’t do this.

[Anonymous]

Ivymount or Auburn.

[Anonymous]

My child was also diagnosed with ADHD and anxiety around this age after a disastrous year in private kindergarten (my child’s birthday was close to the cut off and because they were very academically advanced and doing ok in preschool we were recommended to send them early to kindergarten). It was unbelievably awful and I ended up taking a leave of absence from work for a while to help us get through the year. The thing about private school is they can kick you out at any time, for any reason. Our school was a mainstream private that had a reputation for low child:teacher ratios and meeting kids where they were. But that did not happen at all. Instead they basically threatened us with expulsion all year long and made constant comments about my child and my parenting and the speed with which we were able to get a diagnosis and treatment (which I know realize was extremely fast, probably because we private paid for everything, which we were lucky to be able to do). My biggest parenting regret is not pulling my child out at the first hint of trouble and leaving them in that situation for so long.

I ended up essentially homeschooling for their actual kindergarten year because of COVID and in first they went to public school with an IEP. It was a completely different experience. Each year has been better and my child is now thriving. I swore we would never do private of any kind again. Even SN privates can kick you out if you don’t meet their “profile” and frankly we didn’t find anything that we felt would be remotely appropriate for where our child was academically.

Anyway, I share my experience because it’s easy to be angry and honestly I wish there were better choices around here for privates but at the end of the day I would really encourage you to take a deep breath and focus on what is going to serve your kid right now. The parents counseling you to homeschool may have had similar experiences to mine and want to spare your child the pain of being the despised problem child for a year or more.

You may do best moving (we are in MCPS and I think you can find an elementary school with a strong social education support if you do your research). But pay a lot of attention to how much of a toll this is taking on your child in the meantime. Homeschooling or redshirting can buy you time for a more comprehensive assessment (we saw a developmental pediatrician at KKI after our initial diagnosis) and finding somewhere that is the right fit. Good luck.