Neuropsych for 8yo?

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here. She is in 3rd and this is the year she has started to hate school (but still doing well). Very social too, but definitely needs her down time.
We went to therapy and OT from 4-7yo. They mainly thought anxiety.
Agree that knowing how to parent her is a huge part of this and we’ve come a long way.

I don’t feel like (from what I read) she fits into one clear box for a diagnosis. Am I wrong? We have looked into children’s, but I also question how they would help much from meeting her for one day. Am I completely off and will they get to the bottom of this and give helpful recommendations?

This is when a neuropsych can be useful. It sounds like your kid is has had some pretty impactful struggles in the past. Now at 3rd grade when school is becoming much more difficult she is starting to struggle again. I think a good neuropsych from someone who can confidently diagnose and/or rule out neurodevelopmental and mental health issues and untangle them as well as tease out any weaknesses that may be impacting them educationally even if they are able to compensate can be so useful. With the emotional regulation piece, understanding what might be driving it can help to address it.

The money is an issue. We went with a private evaluation because we were told that and KKI and Children's evals can really vary in quality. We didn't want to go through all that and then as you say get something unclear, inconclusive or incorrect. These reports take time to write so I can definitely see how taking insurance might limit the time the evaluator can spend on a given child. We were able to switch to an insurance plan that reimburses most of the cost for out of network providers so the financial piece was not as much as an issue for us, and I get that we are fortunate in that way.

Because of my kid's history I have really leaned into being proactive in addressing potential issues. I don't really believe in watching and waiting mainly because of trying that approach when DC was young and really regretting it later. And that might not be the right approach for everyone. But from my perspective I think a thorough evaluation sounds like it could be really useful in your kid's case and much better to do it now than waiting until the issues get more complicated in the tween and teen years.

As far as whether the psychologist will really be able to get to know your kid, make sure to gather any reports you may already have. We had early intervention reports and an OT eval and the evaluator was able to talk with the OT that had been working with my kid for months. We were also super detailed in the intake forms. We didn't have concerns that the psychologist didn't know our kid well enough, but definitely I can see how if it was just based on the parent interview hat would not have felt sufficient.

100% the bolded.

We didn’t know what to expect from the evaluation and did not provide detailed written feedback (because we weren’t asked for a detailed written feedback), did not have any prior therapist reports, so the interview and the whole family history intake felt hap-hazardous.

[Anonymous]

I had similar concerns about my now-14 yo. We thought she might have autism or ADHD and finally got a neuropsych last year. Her therapist (who she was seeing for ADHD- the Vanderbilt forms had indicated ADHD) thought she had autism or OCD and she still has meltdowns, is rigid, is super messy and forgetful, etc. Turns out she has anxiety disorder, but no other diagnoses (not even ADHD). She's just a quirky, somewhat prickly, but interesting kid who tries really hard in her way to be a good person. I still think the neuropsych was worth it, to get a better sense of my child, but I think there is definitely an over-pathologizing these days (at least by laypeople) of the normal range of human behaviors.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here. She is in 3rd and this is the year she has started to hate school (but still doing well). Very social too, but definitely needs her down time.
We went to therapy and OT from 4-7yo. They mainly thought anxiety.
Agree that knowing how to parent her is a huge part of this and we’ve come a long way.

I don’t feel like (from what I read) she fits into one clear box for a diagnosis. Am I wrong? We have looked into children’s, but I also question how they would help much from meeting her for one day. Am I completely off and will they get to the bottom of this and give helpful recommendations?

A neuropsych is not some kind of roadmap or even differential diagnosis. It is a series of cognitive tests - like a super duper IQ test. It’s not going to tell you how to parent your kid or differentiate between personality vs anxiety vs subclinical autistic traits. It doesn’t even sound like you are articulating any issue or challenge.

A full neuropsych eval by a skilled psychologist absolutely includes ruling out and/or assessing differential diagnoses (including psychiatric and autism).

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. She is in 3rd and this is the year she has started to hate school (but still doing well). Very social too, but definitely needs her down time.
We went to therapy and OT from 4-7yo. They mainly thought anxiety.
Agree that knowing how to parent her is a huge part of this and we’ve come a long way.

I don’t feel like (from what I read) she fits into one clear box for a diagnosis. Am I wrong? We have looked into children’s, but I also question how they would help much from meeting her for one day. Am I completely off and will they get to the bottom of this and give helpful recommendations?

A neuropsych is not some kind of roadmap or even differential diagnosis. It is a series of cognitive tests - like a super duper IQ test. It’s not going to tell you how to parent your kid or differentiate between personality vs anxiety vs subclinical autistic traits. It doesn’t even sound like you are articulating any issue or challenge.

A full neuropsych eval by a skilled psychologist absolutely includes ruling out and/or assessing differential diagnoses (including psychiatric and autism).

No it doesn’t.

[Anonymous]

Anonymous wrote:A neuropsych won’t get you the information you want. I would start with therapy (for you as a parent to handle difficult behaviors) and go from there.

What? OP I’d ignore this comment because it is baseless. You can spend a lot of time and money on therapy and not really get anywhere. If you don’t know what you are dealing with/have the right therapist for what you need.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. She is in 3rd and this is the year she has started to hate school (but still doing well). Very social too, but definitely needs her down time.
We went to therapy and OT from 4-7yo. They mainly thought anxiety.
Agree that knowing how to parent her is a huge part of this and we’ve come a long way.

I don’t feel like (from what I read) she fits into one clear box for a diagnosis. Am I wrong? We have looked into children’s, but I also question how they would help much from meeting her for one day. Am I completely off and will they get to the bottom of this and give helpful recommendations?

A neuropsych is not some kind of roadmap or even differential diagnosis. It is a series of cognitive tests - like a super duper IQ test. It’s not going to tell you how to parent your kid or differentiate between personality vs anxiety vs subclinical autistic traits. It doesn’t even sound like you are articulating any issue or challenge.

A full neuropsych eval by a skilled psychologist absolutely includes ruling out and/or assessing differential diagnoses (including psychiatric and autism).

No it doesn’t.

Sometimes yes and sometimes no, but for most people I know it was pretty conclusive and for us it was conclusive (anxiety) and a question mark for ADHD which was yes in the end but we could at least get the anxiety under control and that helped us tease out the second part. It’s an art, not a science because every kid—even those with the same diagnosis’s—are different

[Anonymous]

Anonymous wrote:

Anonymous wrote:A neuropsych won’t get you the information you want. I would start with therapy (for you as a parent to handle difficult behaviors) and go from there.

What? OP I’d ignore this comment because it is baseless. You can spend a lot of time and money on therapy and not really get anywhere. If you don’t know what you are dealing with/have the right therapist for what you need.

Absolutely untrue. The waste of time and money is on the expensive testing that isn’t actually necessary for a diagnosis or treatment. Good therapists are absolutely able to treat without a diagnosis - and good psychologists and psychiatrists in fact are quite cognizant of the fact that the diagnostic label can be of limited value in many cases. Plus the information gained in therapy is likely much better to diagnose something like anxiety or autism than a one-day batter of cognitive tests. Many many psychiatric symptoms in kids and adults are cross-diagnostic, particularly the ones OP describes.

If OP said her kid was having learning difficulties that might be a different story but she didn’t say that.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. She is in 3rd and this is the year she has started to hate school (but still doing well). Very social too, but definitely needs her down time.
We went to therapy and OT from 4-7yo. They mainly thought anxiety.
Agree that knowing how to parent her is a huge part of this and we’ve come a long way.

I don’t feel like (from what I read) she fits into one clear box for a diagnosis. Am I wrong? We have looked into children’s, but I also question how they would help much from meeting her for one day. Am I completely off and will they get to the bottom of this and give helpful recommendations?

A neuropsych is not some kind of roadmap or even differential diagnosis. It is a series of cognitive tests - like a super duper IQ test. It’s not going to tell you how to parent your kid or differentiate between personality vs anxiety vs subclinical autistic traits. It doesn’t even sound like you are articulating any issue or challenge.

A full neuropsych eval by a skilled psychologist absolutely includes ruling out and/or assessing differential diagnoses (including psychiatric and autism).

No it doesn’t.

Sometimes yes and sometimes no, but for most people I know it was pretty conclusive and for us it was conclusive (anxiety) and a question mark for ADHD which was yes in the end but we could at least get the anxiety under control and that helped us tease out the second part. It’s an art, not a science because every kid—even those with the same diagnosis’s—are different

You absolutely 100% do not need an all-day “neuropsych” to diagnose anxiety. How absurd.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:A neuropsych won’t get you the information you want. I would start with therapy (for you as a parent to handle difficult behaviors) and go from there.

What? OP I’d ignore this comment because it is baseless. You can spend a lot of time and money on therapy and not really get anywhere. If you don’t know what you are dealing with/have the right therapist for what you need.

Absolutely untrue. The waste of time and money is on the expensive testing that isn’t actually necessary for a diagnosis or treatment. Good therapists are absolutely able to treat without a diagnosis - and good psychologists and psychiatrists in fact are quite cognizant of the fact that the diagnostic label can be of limited value in many cases. Plus the information gained in therapy is likely much better to diagnose something like anxiety or autism than a one-day batter of cognitive tests. Many many psychiatric symptoms in kids and adults are cross-diagnostic, particularly the ones OP describes.

If OP said her kid was having learning difficulties that might be a different story but she didn’t say that.

All of this is false. Diagnosis matters and good psychologists and psychiatrists know this.

A child who seems inattentive might actually be distracted by worry, struggling with impulse control, or overwhelmed by sensory and social demands. ADHD is often tied to attention and inhibition problems, anxiety more to fear and avoidance, and autism more to social communication differences, rigidity, and sensory needs.

The distinction matters because treatments are not interchangeable. For example, ADHD plans often emphasize medication plus school supports and executive-function coaching, while anxiety is usually treated with therapy that targets worry and avoidance, and autism support often focuses on communication, sensory accommodations, and skills-based services.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:A neuropsych won’t get you the information you want. I would start with therapy (for you as a parent to handle difficult behaviors) and go from there.

What? OP I’d ignore this comment because it is baseless. You can spend a lot of time and money on therapy and not really get anywhere. If you don’t know what you are dealing with/have the right therapist for what you need.

Absolutely untrue. The waste of time and money is on the expensive testing that isn’t actually necessary for a diagnosis or treatment. Good therapists are absolutely able to treat without a diagnosis - and good psychologists and psychiatrists in fact are quite cognizant of the fact that the diagnostic label can be of limited value in many cases. Plus the information gained in therapy is likely much better to diagnose something like anxiety or autism than a one-day batter of cognitive tests. Many many psychiatric symptoms in kids and adults are cross-diagnostic, particularly the ones OP describes.

If OP said her kid was having learning difficulties that might be a different story but she didn’t say that.

In our experience the people that treated our child's symptoms were not qualified to distinguish between autism, ADHD and anxiety and said so..they were the ones who referred us to get the neuropsych. The evaluator spoke with them and that was helpful but the testing was important.

As far as whether there are learning difficulties, OP said her child hates school. Persistent school distress is a signal that something needs attention, and the earlier you figure out the cause, the easier it is to help your child feel better and function better

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:A neuropsych won’t get you the information you want. I would start with therapy (for you as a parent to handle difficult behaviors) and go from there.

What? OP I’d ignore this comment because it is baseless. You can spend a lot of time and money on therapy and not really get anywhere. If you don’t know what you are dealing with/have the right therapist for what you need.

Absolutely untrue. The waste of time and money is on the expensive testing that isn’t actually necessary for a diagnosis or treatment. Good therapists are absolutely able to treat without a diagnosis - and good psychologists and psychiatrists in fact are quite cognizant of the fact that the diagnostic label can be of limited value in many cases. Plus the information gained in therapy is likely much better to diagnose something like anxiety or autism than a one-day batter of cognitive tests. Many many psychiatric symptoms in kids and adults are cross-diagnostic, particularly the ones OP describes.

If OP said her kid was having learning difficulties that might be a different story but she didn’t say that.

All of this is false. Diagnosis matters and good psychologists and psychiatrists know this.

A child who seems inattentive might actually be distracted by worry, struggling with impulse control, or overwhelmed by sensory and social demands. ADHD is often tied to attention and inhibition problems, anxiety more to fear and avoidance, and autism more to social communication differences, rigidity, and sensory needs.

The distinction matters because treatments are not interchangeable. For example, ADHD plans often emphasize medication plus school supports and executive-function coaching, while anxiety is usually treated with therapy that targets worry and avoidance, and autism support often focuses on communication, sensory accommodations, and skills-based services.

Literally, my very highly trained child psychologist said the diagnosis made no difference in her approach to my kid (who dealt with issues similar to what OP described). AND if OP really does want to have the kid formally assessed again then the approach is to do a limited assessment not pay $8k for it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:A neuropsych won’t get you the information you want. I would start with therapy (for you as a parent to handle difficult behaviors) and go from there.

What? OP I’d ignore this comment because it is baseless. You can spend a lot of time and money on therapy and not really get anywhere. If you don’t know what you are dealing with/have the right therapist for what you need.

Absolutely untrue. The waste of time and money is on the expensive testing that isn’t actually necessary for a diagnosis or treatment. Good therapists are absolutely able to treat without a diagnosis - and good psychologists and psychiatrists in fact are quite cognizant of the fact that the diagnostic label can be of limited value in many cases. Plus the information gained in therapy is likely much better to diagnose something like anxiety or autism than a one-day batter of cognitive tests. Many many psychiatric symptoms in kids and adults are cross-diagnostic, particularly the ones OP describes.

If OP said her kid was having learning difficulties that might be a different story but she didn’t say that.

All of this is false. Diagnosis matters and good psychologists and psychiatrists know this.

A child who seems inattentive might actually be distracted by worry, struggling with impulse control, or overwhelmed by sensory and social demands. ADHD is often tied to attention and inhibition problems, anxiety more to fear and avoidance, and autism more to social communication differences, rigidity, and sensory needs.

The distinction matters because treatments are not interchangeable. For example, ADHD plans often emphasize medication plus school supports and executive-function coaching, while anxiety is usually treated with therapy that targets worry and avoidance, and autism support often focuses on communication, sensory accommodations, and skills-based services.

Literally, my very highly trained child psychologist said the diagnosis made no difference in her approach to my kid (who dealt with issues similar to what OP described). AND if OP really does want to have the kid formally assessed again then the approach is to do a limited assessment not pay $8k for it.

Literally your kid is a sample of one, you have never met OP's kid and are not qualified to decide for her that a diagnosis doesn't matter for them. Diagnosis matters for many, many kids.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:A neuropsych won’t get you the information you want. I would start with therapy (for you as a parent to handle difficult behaviors) and go from there.

What? OP I’d ignore this comment because it is baseless. You can spend a lot of time and money on therapy and not really get anywhere. If you don’t know what you are dealing with/have the right therapist for what you need.

Absolutely untrue. The waste of time and money is on the expensive testing that isn’t actually necessary for a diagnosis or treatment. Good therapists are absolutely able to treat without a diagnosis - and good psychologists and psychiatrists in fact are quite cognizant of the fact that the diagnostic label can be of limited value in many cases. Plus the information gained in therapy is likely much better to diagnose something like anxiety or autism than a one-day batter of cognitive tests. Many many psychiatric symptoms in kids and adults are cross-diagnostic, particularly the ones OP describes.

If OP said her kid was having learning difficulties that might be a different story but she didn’t say that.

All of this is false. Diagnosis matters and good psychologists and psychiatrists know this.

A child who seems inattentive might actually be distracted by worry, struggling with impulse control, or overwhelmed by sensory and social demands. ADHD is often tied to attention and inhibition problems, anxiety more to fear and avoidance, and autism more to social communication differences, rigidity, and sensory needs.

The distinction matters because treatments are not interchangeable. For example, ADHD plans often emphasize medication plus school supports and executive-function coaching, while anxiety is usually treated with therapy that targets worry and avoidance, and autism support often focuses on communication, sensory accommodations, and skills-based services.

Literally, my very highly trained child psychologist said the diagnosis made no difference in her approach to my kid (who dealt with issues similar to what OP described). AND if OP really does want to have the kid formally assessed again then the approach is to do a limited assessment not pay $8k for it.

That would make me very, very wary if they meant it like you’re presenting it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:A neuropsych won’t get you the information you want. I would start with therapy (for you as a parent to handle difficult behaviors) and go from there.

What? OP I’d ignore this comment because it is baseless. You can spend a lot of time and money on therapy and not really get anywhere. If you don’t know what you are dealing with/have the right therapist for what you need.

Absolutely untrue. The waste of time and money is on the expensive testing that isn’t actually necessary for a diagnosis or treatment. Good therapists are absolutely able to treat without a diagnosis - and good psychologists and psychiatrists in fact are quite cognizant of the fact that the diagnostic label can be of limited value in many cases. Plus the information gained in therapy is likely much better to diagnose something like anxiety or autism than a one-day batter of cognitive tests. Many many psychiatric symptoms in kids and adults are cross-diagnostic, particularly the ones OP describes.

If OP said her kid was having learning difficulties that might be a different story but she didn’t say that.

In our experience the people that treated our child's symptoms were not qualified to distinguish between autism, ADHD and anxiety and said so..they were the ones who referred us to get the neuropsych. The evaluator spoke with them and that was helpful but the testing was important.

As far as whether there are learning difficulties, OP said her child hates school. Persistent school distress is a signal that something needs attention, and the earlier you figure out the cause, the easier it is to help your child feel better and function better

You were referred to do the testing, and you acknowledge that it was helpful for evaluator to talk with the referring specialist. You did all the right things and evaluation was helpful.

But your case is very different from going cold turkey for the neuropsychological evaluation, having them select a random set of tests, and then expecting them to figure out issues after briefly talking to parents and observing the child for 6-8 hours.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:A neuropsych won’t get you the information you want. I would start with therapy (for you as a parent to handle difficult behaviors) and go from there.

What? OP I’d ignore this comment because it is baseless. You can spend a lot of time and money on therapy and not really get anywhere. If you don’t know what you are dealing with/have the right therapist for what you need.

Absolutely untrue. The waste of time and money is on the expensive testing that isn’t actually necessary for a diagnosis or treatment. Good therapists are absolutely able to treat without a diagnosis - and good psychologists and psychiatrists in fact are quite cognizant of the fact that the diagnostic label can be of limited value in many cases. Plus the information gained in therapy is likely much better to diagnose something like anxiety or autism than a one-day batter of cognitive tests. Many many psychiatric symptoms in kids and adults are cross-diagnostic, particularly the ones OP describes.

If OP said her kid was having learning difficulties that might be a different story but she didn’t say that.

In our experience the people that treated our child's symptoms were not qualified to distinguish between autism, ADHD and anxiety and said so..they were the ones who referred us to get the neuropsych. The evaluator spoke with them and that was helpful but the testing was important.

As far as whether there are learning difficulties, OP said her child hates school. Persistent school distress is a signal that something needs attention, and the earlier you figure out the cause, the easier it is to help your child feel better and function better

You were referred to do the testing, and you acknowledge that it was helpful for evaluator to talk with the referring specialist. You did all the right things and evaluation was helpful.

But your case is very different from going cold turkey for the neuropsychological evaluation, having them select a random set of tests, and then expecting them to figure out issues after briefly talking to parents and observing the child for 6-8 hours.

That is fair, but while OP waits for the evaluation which is usually at least several months, even for private, they can start services. Btw we only got referred because we proactively reached out to the psychologist who had completed treatment with our child to ask about next steps. Our experience was that the therapists were very hesitant to name their concerns about autism or be explicit about the need for an evaluation. The notion that it will be obvious and clear that your kid needs an eval is false. OP knows her kid better than anyone.