How many second opinions? Or when to stop assessing preschooler if nothing seems to fit?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Shapiro takes new patients who are 4 yrs old and younger so you have a lot of time to get him. GL!

No, she doesn't. Her DD will be four in March. That's in three months. Having BTDT, she will never get in with Shapiro. Not trying to be discouraging, it's just a fact.

Dr. Shapiro is our developmental ped and he takes new patients who are 4 yrs old and younger. DS became Shapiro's patient when he was four yrs old.

[Anonymous]

16:41 here. We went in two steps. He spent a month in our former daycare in DC before we moved. Then he started at his school in our new location. I went with him a couple of times for a few hours first. The first day I dropped him off to be on his own, he ran into start playing and said "bye, Mom!". I almost passed out.

We've had 1 or 2 incidents and he still occasionally has his moments, but by and large it's night and day. It's now been 5 months since we left that hideous charter and we feel like we have our kid back.

You may also want to investigate any medical causes for your daughter's behavior. Our son has had sleep issues since right after his third birthday and was recently diagnosed with sleep apnea. He'll be having a tonsillectomy and adenoidectomy soon and the ENT told us we can expect not only better sleep but better overall behavior as a result.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Shapiro takes new patients who are 4 yrs old and younger so you have a lot of time to get him. GL!

No, she doesn't. Her DD will be four in March. That's in three months. Having BTDT, she will never get in with Shapiro. Not trying to be discouraging, it's just a fact.

Dr. Shapiro is our developmental ped and he takes new patients who are 4 yrs old and younger. DS became Shapiro's patient when he was four yrs old.

Yes, I get that. Point is when I called to try and get in with him, and was told they were not taking new patients, they told me it would be a six month wait. OP can try, but with three months to go until her DD turns 4, her chances aren't great. All of Washington tries to get in with him
. The man only has so many hours in a day.

[Anonymous]

Anonymous wrote:16:41 here. We went in two steps. He spent a month in our former daycare in DC before we moved. Then he started at his school in our new location. I went with him a couple of times for a few hours first. The first day I dropped him off to be on his own, he ran into start playing and said "bye, Mom!". I almost passed out.

We've had 1 or 2 incidents and he still occasionally has his moments, but by and large it's night and day. It's now been 5 months since we left that hideous charter and we feel like we have our kid back.

You may also want to investigate any medical causes for your daughter's behavior. Our son has had sleep issues since right after his third birthday and was recently diagnosed with sleep apnea. He'll be having a tonsillectomy and adenoidectomy soon and the ENT told us we can expect not only better sleep but better overall behavior as a result.

Sleep deprivation is a huge part of the problem, for lots of families.

[Anonymous]

Does he only take patients under 4 or does he take patients under 5 who are still 4?

[Anonymous]

Anonymous wrote:Does he only take patients under 4 or does he take patients under 5 who are still 4?

Takes new patients Under 5, who are four. As long as you get on his wait list prior to your child turning five, you'll be fine.

[Anonymous]

She isn't really delayed in anything, but there's a sense that she's "different" because she's so unusual in how she imagines things and plays. It is more a matter of figuring out the cause of sudden, intense negative behaviors. And if there isn't a cause, training her to manage them appropriately. While at the same time, we want to preserve the positive parts of how creative she is.

First of all, you've done a great job in looking for assistance for your DD. That's really commendable - and exhausting and expensive!

From your post, other than the negative behaviors, I'm not seeing a lot in your postings that would indicate you should continue to pursue anything more at this time. I think it was premature of the KKI NP to rule out ADHD. It would be difficult to diagnose it at this age if she has the inattentive component but negative behaviors often have an emotional regulation issue to them. Whether that would be ADHD or not remains to be seen because as a PP noted, there' a lot of symptom overlap with disorders. Or, it could just be your DD has issues with emotional regulation. She wouldn't be the first. And, managing her negative behaviors shouldn't impact her creativity

[Anonymous]

OP,

Shapiro isn't the only game in town. Yes, probably the only or one of the few developmental pediatrician's who will do an observation, but many qualified psychologists will as well. So don't feel like it's a one-shot deal.

If these behaviors have been going on since April, I would re-assess the school setting and consider switching schools. It sounds like stress that's situational. Usually, there are indicators when you have a more global SN and it's not a sudden onset.

Sometimes diagnoses dribble in a little here a little there, but even with a diagnosis the right school setting can really make the difference for a kid.

[Anonymous]

PP, would you mind sharing which charter you left?

[Anonymous]

We gave up on trying to get a definite DX a while ago. We got so many labels that flipped between "just a language disorder" and "autism spectrum." He has had DXs of MERLD, social pragmatic language disorder, autism, Asperger's, autism spectrum disorder, ADHD. Between 5 and 11, he has been assessed by two psychologists, 3 speech language pathologists, and a school social worker. He also had a work-up at an autism clinic. He's taken the COGAT and had the WISC twice. He's had an ADOS and an ADI-R. He's had a bunch of other tests from the psychologists and the ST.

Eff that. We get the assessments we need to stay qualified for IEP services and to identify his deficits. We are getting pretty far with him just by identifying deficits and targeting those deficits.

[Anonymous]

Anonymous wrote:We gave up on trying to get a definite DX a while ago. We got so many labels that flipped between "just a language disorder" and "autism spectrum." He has had DXs of MERLD, social pragmatic language disorder, autism, Asperger's, autism spectrum disorder, ADHD. Between 5 and 11, he has been assessed by two psychologists, 3 speech language pathologists, and a school social worker. He also had a work-up at an autism clinic. He's taken the COGAT and had the WISC twice. He's had an ADOS and an ADI-R. He's had a bunch of other tests from the psychologists and the ST.

Eff that. We get the assessments we need to stay qualified for IEP services and to identify his deficits. We are getting pretty far with him just by identifying deficits and targeting those deficits.

These things are all tied together. MERLD affects pragmatics, autism/Aspergers affects pragmatics, even ADHD affects pragmatics. So at least there is a common theme (pragmatics) regardless of the actual cause.

In OP's case the ChildLink person and new teacher suspect something like "ADHD/autism spectrum/anxiety." The daycare director and teacher think that KKI got it wrong in ruling ASD and ADHD. However, the one thing that you can get in a kid who has ADHD or autism is anxiety. So I think that's the common denominator for the OP to focus on for the time being.

Her kid is still very young. This bump in the road might be just that or this is a little piece of the bigger picture. So even without a clear cut diagnosis, treating the symptoms are important.

[Anonymous]

OP, for complex kids diagnosis can be a process, not an event. You have a good idea of what needs to be worked on. Treat the biggest problems, then see where you are. When your Dc is a bit older, do another round of evaluations and see how things have evolved.

[Anonymous]

Anonymous wrote:OP, for complex kids diagnosis can be a process, not an event. You have a good idea of what needs to be worked on. Treat the biggest problems, then see where you are. When your Dc is a bit older, do another round of evaluations and see how things have evolved.

This is exactly right. Sometimes you treat the biggest thing, you see success but realize there are still problems, and it helps identify a different issue. When there are comorbidities this is often the case.

[Anonymous]

I feel your pain, OP. I was given three different diagnoses for my-then 5 year old, ranging from PDD-NOS to full blown autism to severe ADHD. I was told he would never be able to function in a mainstream school, he should be in a school for kids with severe autism, etc. Fast forward, he's now 14, his one and only diagnosis is ADHD/Inattentive, is enrolled in honors courses in his school, participates in Johns Hopkins CTY. And yes, I was told we would be lucky if he can spell or write his name.

What I am trying to say is that sometimes you need to go with your gut. What does your gut tell you are his biggest problems? Is it social speech? Is it his hyperactivity?

[Anonymous]

Anonymous wrote:I feel your pain, OP. I was given three different diagnoses for my-then 5 year old, ranging from PDD-NOS to full blown autism to severe ADHD. I was told he would never be able to function in a mainstream school, he should be in a school for kids with severe autism, etc. Fast forward, he's now 14, his one and only diagnosis is ADHD/Inattentive, is enrolled in honors courses in his school, participates in Johns Hopkins CTY. And yes, I was told we would be lucky if he can spell or write his name.

What I am trying to say is that sometimes you need to go with your gut. What does your gut tell you are his biggest problems? Is it social speech? Is it his hyperactivity?

Amen, PP. Amen. OP, these boards are rife with stories like this of utter quacks whose "diagnoses" were not worth the paper on which they were written. YOU are the one and only expert on your child. If you feel what the doctors are telling you is off, do not for one moment doubt yourself. I did and I still have guilt about what my kid went through. And anger at the utterly incompetent "experts" who were more enamored of their own diplomas than anything else.