neuro-psych evaluation --does it always equal a diagnosis?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
To avoid mis-diagnosing your child and wasting your money, you just have to follow two simple rules:

1. DO choose a reputable developmental ped. or psychologist, who is specialized in the issues you are worried about. These have years of experience and will NEVER see a diagnosis where one does not exist, and even then they will usually err on the conservative side (say the disorder is mild instead of moderate or severe). The ones to watch out for are the general peds or bad psychologists - they have no clue what they're doing.

2. Do NOT test too young, or if you do, expect the diagnosis to evolve, or if no diagnosis is given, plan to retest a few years later to see if your child is diagnosable then. Young children are not reliable test-takers before late elementary! The full neuro-psychological evaluation for my 10 year old at Stixrud's lasted 8 or so hours. When children are too young, their reading and understanding of concepts are not developed enough to do in-depth testing and tease out different but similarly-presenting disorders (ex: social issues stemming from inattentive ADHD or mild Asperger's).

PP who wrote the above. Let me just add that motor, speech and social development in infants and toddlers do not come under the neuro-psych umbrella. For this you go to a developmental ped who will evaluate your child and possibly refer him to occupational, physical, speech or play therapists, etc, as early intervention is absolutely critical. From the bent of OP's question, I understood he or she had an older child who exhibited symptoms of a more behavioral/academic/emotional nature, which would necessitate a neuro-psychological evaluation.

Hmmmm. Do you want to know why those probably don't come under the "neuro-psych umbrella"? Because there's little evidence that interventions there work. But please prove me wrong: Show me well-published references of randomized controlled trials proving that diagnostic X by a ped leads to treatment Y and to neuro/ behavioral benefits A, B and C.

Wrong. Delays in early infancy affect much larger swathes of functioning (not talking, not walking on time, not making eye contact) and are simply not diagnosed with the same tests. A neuro-psychological evaluation tests *comparatively* subtler aspects of cognitive abilities and mental control. Responses typically need some level of listening, focusing and understanding directions, with verbal abilities to match.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
To avoid mis-diagnosing your child and wasting your money, you just have to follow two simple rules:

1. DO choose a reputable developmental ped. or psychologist, who is specialized in the issues you are worried about. These have years of experience and will NEVER see a diagnosis where one does not exist, and even then they will usually err on the conservative side (say the disorder is mild instead of moderate or severe). The ones to watch out for are the general peds or bad psychologists - they have no clue what they're doing.

2. Do NOT test too young, or if you do, expect the diagnosis to evolve, or if no diagnosis is given, plan to retest a few years later to see if your child is diagnosable then. Young children are not reliable test-takers before late elementary! The full neuro-psychological evaluation for my 10 year old at Stixrud's lasted 8 or so hours. When children are too young, their reading and understanding of concepts are not developed enough to do in-depth testing and tease out different but similarly-presenting disorders (ex: social issues stemming from inattentive ADHD or mild Asperger's).

PP who wrote the above. Let me just add that motor, speech and social development in infants and toddlers do not come under the neuro-psych umbrella. For this you go to a developmental ped who will evaluate your child and possibly refer him to occupational, physical, speech or play therapists, etc, as early intervention is absolutely critical. From the bent of OP's question, I understood he or she had an older child who exhibited symptoms of a more behavioral/academic/emotional nature, which would necessitate a neuro-psychological evaluation.

Hmmmm. Do you want to know why those probably don't come under the "neuro-psych umbrella"? Because there's little evidence that interventions there work. But please prove me wrong: Show me well-published references of randomized controlled trials proving that diagnostic X by a ped leads to treatment Y and to neuro/ behavioral benefits A, B and C.

Are you saying that you doubt that speech therapy helps with speech delays or that physical therapy helps with gross motor delays?

[Anonymous]

Anonymous wrote:

Anonymous wrote:If you didn't think there was a problem, why would you even consider an evaluation. And, if there is something wrong, why do you want the evaluator to come back with nothing? Your whole post baffles me.

That being said, my son did not get a diagnosis from his eval. We got a lot of information that was very helpful. The information included problems and suggestions for working with him. But, diagnosis? Nope.

Not OP, but we are considering testing but do not necessarily think there is a problem. DC's teacher is insistent something is wrong with him. He is not the easiest child, but we've never thought his behavior suggested a larger problem - although of course, we are concerned he's having so much trouble behaving in school. We've already had one therapist tell us there is no diagnosis (no formal testing), but teacher is insistent and we don't want to ignore her concerns. On the one hand, we want to be sure and don't want to miss something - obviously if there is something to her concerns, we want to get DC intervention as soon as possible. On the other, I wouldn't be surprised if there was no diagnosis (or if there was one - I think it could go either way).

You could start with a screening -- really quick and simple evaluation and short battery by a professional (not a teacher who is not trained in this), who will simply let you know whether further evaluation is warranted and if so in which areas. Our pediatrician's office offers such screenings with a specialist, but there are others out there.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
To avoid mis-diagnosing your child and wasting your money, you just have to follow two simple rules:

1. DO choose a reputable developmental ped. or psychologist, who is specialized in the issues you are worried about. These have years of experience and will NEVER see a diagnosis where one does not exist, and even then they will usually err on the conservative side (say the disorder is mild instead of moderate or severe). The ones to watch out for are the general peds or bad psychologists - they have no clue what they're doing.

2. Do NOT test too young, or if you do, expect the diagnosis to evolve, or if no diagnosis is given, plan to retest a few years later to see if your child is diagnosable then. Young children are not reliable test-takers before late elementary! The full neuro-psychological evaluation for my 10 year old at Stixrud's lasted 8 or so hours. When children are too young, their reading and understanding of concepts are not developed enough to do in-depth testing and tease out different but similarly-presenting disorders (ex: social issues stemming from inattentive ADHD or mild Asperger's).

PP who wrote the above. Let me just add that motor, speech and social development in infants and toddlers do not come under the neuro-psych umbrella. For this you go to a developmental ped who will evaluate your child and possibly refer him to occupational, physical, speech or play therapists, etc, as early intervention is absolutely critical. From the bent of OP's question, I understood he or she had an older child who exhibited symptoms of a more behavioral/academic/emotional nature, which would necessitate a neuro-psychological evaluation.

Hmmmm. Do you want to know why those probably don't come under the "neuro-psych umbrella"? Because there's little evidence that interventions there work. But please prove me wrong: Show me well-published references of randomized controlled trials proving that diagnostic X by a ped leads to treatment Y and to neuro/ behavioral benefits A, B and C.

NP. We had a long discussion with our neuropsych about social skills classes. There are no long term studies that they really work. Sure there are several "evidenced based" curriculums but no long term studies ( longer than ~2 yrs) that these things make any real difference in the long term.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:If you didn't think there was a problem, why would you even consider an evaluation. And, if there is something wrong, why do you want the evaluator to come back with nothing? Your whole post baffles me.

That being said, my son did not get a diagnosis from his eval. We got a lot of information that was very helpful. The information included problems and suggestions for working with him. But, diagnosis? Nope.

Not OP, but we are considering testing but do not necessarily think there is a problem. DC's teacher is insistent something is wrong with him. He is not the easiest child, but we've never thought his behavior suggested a larger problem - although of course, we are concerned he's having so much trouble behaving in school. We've already had one therapist tell us there is no diagnosis (no formal testing), but teacher is insistent and we don't want to ignore her concerns. On the one hand, we want to be sure and don't want to miss something - obviously if there is something to her concerns, we want to get DC intervention as soon as possible. On the other, I wouldn't be surprised if there was no diagnosis (or if there was one - I think it could go either way).

You could start with a screening -- really quick and simple evaluation and short battery by a professional (not a teacher who is not trained in this), who will simply let you know whether further evaluation is warranted and if so in which areas. Our pediatrician's office offers such screenings with a specialist, but there are others out there.

Ours does too... for toddlers. If OP's kid is old enough for a neuropsych, the recommended age is 7+, the screenings won't help much unless it's for pretty obvious, severe ADHD.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
To avoid mis-diagnosing your child and wasting your money, you just have to follow two simple rules:

1. DO choose a reputable developmental ped. or psychologist, who is specialized in the issues you are worried about. These have years of experience and will NEVER see a diagnosis where one does not exist, and even then they will usually err on the conservative side (say the disorder is mild instead of moderate or severe). The ones to watch out for are the general peds or bad psychologists - they have no clue what they're doing.

2. Do NOT test too young, or if you do, expect the diagnosis to evolve, or if no diagnosis is given, plan to retest a few years later to see if your child is diagnosable then. Young children are not reliable test-takers before late elementary! The full neuro-psychological evaluation for my 10 year old at Stixrud's lasted 8 or so hours. When children are too young, their reading and understanding of concepts are not developed enough to do in-depth testing and tease out different but similarly-presenting disorders (ex: social issues stemming from inattentive ADHD or mild Asperger's).

PP who wrote the above. Let me just add that motor, speech and social development in infants and toddlers do not come under the neuro-psych umbrella. For this you go to a developmental ped who will evaluate your child and possibly refer him to occupational, physical, speech or play therapists, etc, as early intervention is absolutely critical. From the bent of OP's question, I understood he or she had an older child who exhibited symptoms of a more behavioral/academic/emotional nature, which would necessitate a neuro-psychological evaluation.

Hmmmm. Do you want to know why those probably don't come under the "neuro-psych umbrella"? Because there's little evidence that interventions there work. But please prove me wrong: Show me well-published references of randomized controlled trials proving that diagnostic X by a ped leads to treatment Y and to neuro/ behavioral benefits A, B and C.

NP. We had a long discussion with our neuropsych about social skills classes. There are no long term studies that they really work. Sure there are several "evidenced based" curriculums but no long term studies ( longer than ~2 yrs) that these things make any real difference in the long term.

Anyone, show me ONE randomized controlled trial published in a good journal that shows a "social skills" intervention works to treat condition A.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
To avoid mis-diagnosing your child and wasting your money, you just have to follow two simple rules:

1. DO choose a reputable developmental ped. or psychologist, who is specialized in the issues you are worried about. These have years of experience and will NEVER see a diagnosis where one does not exist, and even then they will usually err on the conservative side (say the disorder is mild instead of moderate or severe). The ones to watch out for are the general peds or bad psychologists - they have no clue what they're doing.

2. Do NOT test too young, or if you do, expect the diagnosis to evolve, or if no diagnosis is given, plan to retest a few years later to see if your child is diagnosable then. Young children are not reliable test-takers before late elementary! The full neuro-psychological evaluation for my 10 year old at Stixrud's lasted 8 or so hours. When children are too young, their reading and understanding of concepts are not developed enough to do in-depth testing and tease out different but similarly-presenting disorders (ex: social issues stemming from inattentive ADHD or mild Asperger's).

PP who wrote the above. Let me just add that motor, speech and social development in infants and toddlers do not come under the neuro-psych umbrella. For this you go to a developmental ped who will evaluate your child and possibly refer him to occupational, physical, speech or play therapists, etc, as early intervention is absolutely critical. From the bent of OP's question, I understood he or she had an older child who exhibited symptoms of a more behavioral/academic/emotional nature, which would necessitate a neuro-psychological evaluation.

Hmmmm. Do you want to know why those probably don't come under the "neuro-psych umbrella"? Because there's little evidence that interventions there work. But please prove me wrong: Show me well-published references of randomized controlled trials proving that diagnostic X by a ped leads to treatment Y and to neuro/ behavioral benefits A, B and C.

Are you saying that you doubt that speech therapy helps with speech delays or that physical therapy helps with gross motor delays?

Sounds too obvious, right?

Well, SHOW US THE EVIDENCE.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

NP. We had a long discussion with our neuropsych about social skills classes. There are no long term studies that they really work. Sure there are several "evidenced based" curriculums but no long term studies ( longer than ~2 yrs) that these things make any real difference in the long term.

Anyone, show me ONE randomized controlled trial published in a good journal that shows a "social skills" intervention works to treat condition A.

Here you go: http://www.ncbi.nlm.nih.gov/pubmed/24256459

Show me a shred of evidence that you're not a f*ckin' idiot. P.S. It's not a "neuropsych" it's a psychologist. You really aren't qualified to give any kind of advice. You also have zero concept of how research works. Your poor kid.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:If you didn't think there was a problem, why would you even consider an evaluation. And, if there is something wrong, why do you want the evaluator to come back with nothing? Your whole post baffles me.

That being said, my son did not get a diagnosis from his eval. We got a lot of information that was very helpful. The information included problems and suggestions for working with him. But, diagnosis? Nope.

Not OP, but we are considering testing but do not necessarily think there is a problem. DC's teacher is insistent something is wrong with him. He is not the easiest child, but we've never thought his behavior suggested a larger problem - although of course, we are concerned he's having so much trouble behaving in school. We've already had one therapist tell us there is no diagnosis (no formal testing), but teacher is insistent and we don't want to ignore her concerns. On the one hand, we want to be sure and don't want to miss something - obviously if there is something to her concerns, we want to get DC intervention as soon as possible. On the other, I wouldn't be surprised if there was no diagnosis (or if there was one - I think it could go either way).

You could start with a screening -- really quick and simple evaluation and short battery by a professional (not a teacher who is not trained in this), who will simply let you know whether further evaluation is warranted and if so in which areas. Our pediatrician's office offers such screenings with a specialist, but there are others out there.

Thanks for the suggestion. Who is your pediatrician? Or can you recommend someone who does this? Our pediatrician was not very helpful. She initially echoed the therapist who said there was no ASD/ADHD concern but when teacher kept pressing she referred us to someone who basically suggested the full evaluation after talking to me for five minutes. Obviously I want to figure out if there is a problem but I definitely don't want to spend thousands if I don't need too (especially since I am skeptical of the need).

[Anonymous]

OP,

Stop hiding the ball. How old is your kid and what kind of "therapist" screened him/her. You can't do a quick screen for ASD or ADHD. You can do checklists that might point to concerns but that's not definitive. Talk to your health insurance and find out what is covered. If money is truly an issue, NIH has clinical trials all the time. The screenings are free if your kid qualifies.

You're "skeptical" but you haven't done any of the heavy lifting. You've sought out a therapist of some kind for some reason. Your pediatrician cannot diagnose ASD or ADHD. If those are your concerns, you need to bite the bullet.

[Anonymous]

Oh, just for 22:45, http://www.nihr.ac.uk/funding/fundingdetails.htm?postid=1527

To meet the "two year" qualification you pulled out of your ass.

[Anonymous]

Just so you know OP if the therapist to which you are referring is an OT, they are NOT qualified to screen kids for ASD or ADHD or say that "there are no signs." You'd actually need to go to a developmental pediatrician. Our insurance covered half the cost.

[Anonymous]

Anonymous wrote:Oh, just for 22:45, http://www.nihr.ac.uk/funding/fundingdetails.htm?postid=1527

To meet the "two year" qualification you pulled out of your ass.

This is a study of how peer support is important for adults recently released from psychiatric hospitals. What does this have anything to do with social skills groups for children?

[Anonymous]

Anonymous wrote:OP,

Stop hiding the ball. How old is your kid and what kind of "therapist" screened him/her. You can't do a quick screen for ASD or ADHD. You can do checklists that might point to concerns but that's not definitive. Talk to your health insurance and find out what is covered. If money is truly an issue, NIH has clinical trials all the time. The screenings are free if your kid qualifies.

You're "skeptical" but you haven't done any of the heavy lifting. You've sought out a therapist of some kind for some reason. Your pediatrician cannot diagnose ASD or ADHD. If those are your concerns, you need to bite the bullet.

+1 You can ask your public school for an evaluation. It will be a psychoeducational evaluation but it will not cost you anything and if it highlights any issues you can schedule your child for a private neuropsych at your cost or ask for an independent educational evaluation which the school system will pay for.

But if the teacher is raising concerns, it'll be well worth it to investigate whether your child needs help instead of dismissing the teacher's concerns because you don't think there is a problem. Obviously, your child is having "problems" at school.

How old is your kid?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:
To avoid mis-diagnosing your child and wasting your money, you just have to follow two simple rules:

1. DO choose a reputable developmental ped. or psychologist, who is specialized in the issues you are worried about. These have years of experience and will NEVER see a diagnosis where one does not exist, and even then they will usually err on the conservative side (say the disorder is mild instead of moderate or severe). The ones to watch out for are the general peds or bad psychologists - they have no clue what they're doing.

2. Do NOT test too young, or if you do, expect the diagnosis to evolve, or if no diagnosis is given, plan to retest a few years later to see if your child is diagnosable then. Young children are not reliable test-takers before late elementary! The full neuro-psychological evaluation for my 10 year old at Stixrud's lasted 8 or so hours. When children are too young, their reading and understanding of concepts are not developed enough to do in-depth testing and tease out different but similarly-presenting disorders (ex: social issues stemming from inattentive ADHD or mild Asperger's).

PP who wrote the above. Let me just add that motor, speech and social development in infants and toddlers do not come under the neuro-psych umbrella. For this you go to a developmental ped who will evaluate your child and possibly refer him to occupational, physical, speech or play therapists, etc, as early intervention is absolutely critical. From the bent of OP's question, I understood he or she had an older child who exhibited symptoms of a more behavioral/academic/emotional nature, which would necessitate a neuro-psychological evaluation.

Hmmmm. Do you want to know why those probably don't come under the "neuro-psych umbrella"? Because there's little evidence that interventions there work. But please prove me wrong: Show me well-published references of randomized controlled trials proving that diagnostic X by a ped leads to treatment Y and to neuro/ behavioral benefits A, B and C.

NP. We had a long discussion with our neuropsych about social skills classes. There are no long term studies that they really work. Sure there are several "evidenced based" curriculums but no long term studies ( longer than ~2 yrs) that these things make any real difference in the long term.

Anyone, show me ONE randomized controlled trial published in a good journal that shows a "social skills" intervention works to treat condition A.

How would you go about doing a randomized trial like the one you are seeking?