Would you pay for a neuropsych for this teen girl?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Husband and son have ADHD and ASD.
DS also has learning disabilities and low processing speed and needed a LOT of services and accommodations in school, and still has some in college.
8th grader DD is an over-achiever in school and clearly has a high IQ, but is also very anxious, cries often, has slightly morbid interests (writes and draws suspense and horror subjects) and has expressed, on two occasions, suicidal thoughts that she then claimed were not serious. I am also wondering if her very high functioning masks ADHD, because sometimes she drops the ball in a way that makes me think of her older brother.

I want to treat her malaise and anxiety in the best way, and for this I'd like to know whether there's any ADHD, or possibly (but I doubt it) autism going on. She does not need any academic services or accommodations in school pertaining to her psychological profile right now, and might never need anything in that line. It's more of a "how do we approach the anxiety, emotional outbursts and destructive thinking" sort of thing. I also don't know what's "normal" emotions for a teen girl.

Is it worth dropping 5K+? My son's needs were so immediate and extreme that we had to get him evaluated for him not to fail in elementary school. As a result, I don't quite know how to evaluate my daughter's needs.

Thank you for your suggestions.

Why would you have children with a man who has adhd and asd?

I didn't know
He's extremely smart, PP, and his profile has definitely helped him in his career. it also makes him hard to live with, sometimes.

PP is a troll. No lower form of trolling than trolling a kids special needs forum. They can rot in hell.

[Anonymous]

A Neuropsych would probably be helpful if you can afford it.

She definitely needs therapy. A DBT group program might be an option If she’s resistant to an individual therapist. If I were you, (assuming you live in the DMV), I would consult with someone at either the DBT center of greater Washington or at Rathbone associates and see what they recommend.

[Anonymous]

She sounds like a teenager, but take her to a developmental pediatrician or neurologist since you’re concerned.

[Anonymous]

DP but to add to PP, OP has mentioned anxiety and social anxiety. Sometimes that stems from untreated ADD, sometimes it is comorbid.

[Anonymous]

CBT and DBT to learn to manage anxiety are more beneficial than talk therapy.

PPs please stop harassing OP. We don't do that in this sub.

[Anonymous]

Rule out any possible medical reasons first.

If you can afford it, I would get her on a waitlist for a neuropsych. We used Dr. Yael Rothman at Stixrud who I had heard was good for gifted youth and she was excellent.

We waited to have our DD evaluated until after high school, and I so wish we had done it earlier. There was so much she was hiding in middle school (bullying, suicide attempts, etc.) and we had no idea except for occasional outbursts which we chalked up to hormones. Grades, extracurriculars, social life all seemed fine for the most part.

Everything went downhill in her high school magnet program. She previously had a diagnosis of anxiety and depression (and was on meds and in therapy), but neuropsych testing showed ADHD (primarily inattentive) even though she had been given a quick computer test for ADHD years before and had passed. There was so much shame (for years) that she internalized due to hiding her executive function/ADHD issues.

I recommend that you get the neuropsych done sooner rather than later (though you might need another one done before college if accommodations are needed then). If hormones are in play, birth control pills were helpful for DD's intense PMS symptoms.

Good luck, OP.

[Anonymous]

Anonymous wrote:
OP again. I know everyone keeps recommending therapy, but... isn't the first order of business to get a diagnosis? Otherwise, since there are many forms of therapy, how would patients or families know which one is best? Or does everyone try blindly to see what works?

No you don't need an official diagnosis to start. She is anxious and cries a lot - go see a therapist!! Even with a diagnosis you don't know which therapist your kid will click with, there can be trial and error in that department. CBT is often recommended for anxiety.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Husband and son have ADHD and ASD.
DS also has learning disabilities and low processing speed and needed a LOT of services and accommodations in school, and still has some in college.
8th grader DD is an over-achiever in school and clearly has a high IQ, but is also very anxious, cries often, has slightly morbid interests (writes and draws suspense and horror subjects) and has expressed, on two occasions, suicidal thoughts that she then claimed were not serious. I am also wondering if her very high functioning masks ADHD, because sometimes she drops the ball in a way that makes me think of her older brother.

I want to treat her malaise and anxiety in the best way, and for this I'd like to know whether there's any ADHD, or possibly (but I doubt it) autism going on. She does not need any academic services or accommodations in school pertaining to her psychological profile right now, and might never need anything in that line. It's more of a "how do we approach the anxiety, emotional outbursts and destructive thinking" sort of thing. I also don't know what's "normal" emotions for a teen girl.

Is it worth dropping 5K+? My son's needs were so immediate and extreme that we had to get him evaluated for him not to fail in elementary school. As a result, I don't quite know how to evaluate my daughter's needs.

Thank you for your suggestions.

Does she have a therapist? I'd start there and then assess whether you need many thousands of dollars worth of tests. If you don't need school accommodations, there's really very little need (usually, not always) for a neuropsych. Between a therapist and a doctor (whether PCP or psychiatrist), you'll most likely get what she needs.

She does not yet have a therapist - she doesn't want one. I think she knows she'd have trouble opening up to someone (social anxiety) and she is scared of trying.

If her anxiety is getting in the way of her accessing therapy, then I would consider an SSRI. And then I would have her work with a good anxiety specialist therapist to get their opinion before doing a full neuropsych.

[Anonymous]

I would do a neuropsych if you can afford it because it’s important to get a diagnosis for treatment - e.g. type of therapy and medication. In the meantime you can try an SSRI. I would not do a stimulant med alone to start because it could exacerbate the anxiety. Good luck, OP!

[Anonymous]

If you can afford it, I'd say get the neuropsych now because if she does need accommodations in the future, you'll need the diagnosis. And if therapy is one of the recommendations, she might be more open to having it come from someone else, not you. She could be on a waiting list for a neuropsych for a while. Make the appointment. You can always cancel it if you change your mind.

[Anonymous]

Anonymous wrote:
OP again. I know everyone keeps recommending therapy, but... isn't the first order of business to get a diagnosis? Otherwise, since there are many forms of therapy, how would patients or families know which one is best? Or does everyone try blindly to see what works?

Your pediatrician can give you the diagnosis or refer you to a psychiatrist.

[Anonymous]

100% yes. Objective data is helpful, especially with high IQ kids who can often compensate for a long time without a proper diagnosis but inside it is really taking a toll. Ask me how I know.

[Anonymous]

Anonymous wrote:Rule out any possible medical reasons first.

If you can afford it, I would get her on a waitlist for a neuropsych. We used Dr. Yael Rothman at Stixrud who I had heard was good for gifted youth and she was excellent.

We waited to have our DD evaluated until after high school, and I so wish we had done it earlier. There was so much she was hiding in middle school (bullying, suicide attempts, etc.) and we had no idea except for occasional outbursts which we chalked up to hormones. Grades, extracurriculars, social life all seemed fine for the most part.

Everything went downhill in her high school magnet program. She previously had a diagnosis of anxiety and depression (and was on meds and in therapy), but neuropsych testing showed ADHD (primarily inattentive) even though she had been given a quick computer test for ADHD years before and had passed. There was so much shame (for years) that she internalized due to hiding her executive function/ADHD issues.

I recommend that you get the neuropsych done sooner rather than later (though you might need another one done before college if accommodations are needed then). If hormones are in play, birth control pills were helpful for DD's intense PMS symptoms.

Good luck, OP.

+1

NP. Given other family members’ diagnoses, recommend having your daughter screened for both ADHD and ASD.

My DD was late diagnosed ASD in high school after suicidal thoughts/burnout/shutdown led to school refusal for last six weeks of last school year. DD has been in magnate programs since elementary school and treated for GAD and OCD for years with moderate success, but everything went downhill last spring. She had been majorly compensating and masking and just couldn’t sustain it any more.

Girls often have an internal presentation for ASD and can mask so successfully (but at great cost). Research on and identification of ASD in girls is woefully behind, but it is starting to catch up to the need.