Is neuropsych needed in our case

[Anonymous]

For people who are astounded by 3 ADOS rounds by age 10 are missing the point that the OP on top of his/her kid's delays. When they're administered to a very young kid, it's pretty basic and involve things like blowing up a balloon. It's not a big deal at all.

The point of doing a neuropsych evaluation is ultimately to determine what educational supports and/or related therapies would help. As a parent, I two would err on the side of doing a full evaluation and not just the ADOS.

A neuropsych can evaluate for autism, but it can also screen for possible additional diagnoses such as...
-- anxiety and/or ADHD which can't be diagnosed by the ADOS alone. If this is the case, you may want to consider medications.
--dyslexia or dysgraphia (which would impact his executive functioning)
Or your kid could end up with a diagnosis of Social Communication Pragmatics Disorder--and while not autism would probably require the same in terms of educational supports.

OP, when you went to KKI did you meet with a developmental pediatrician? Did they flag any motor coordination issues?

[Anonymous]

OP,

The fact that they closed his IEP means that in addition to being on grade level, he's not a behavioral "problem." If he had the outbursts at school that you describe he has at home, he probably would have and IEP still. The fact that your psychologist is actively dissuading you from getting a full evaluation given all the behavioral difficulty he's having at home, gives me pause.

You may want to prepare yourself that your child is on the spectrum. Regardless, he still sounds like he needs help b/c the outbursts are affecting his quality of life (and yours). I would dump this therapist and use the money you're spending on CBT for a summer camp that helps reinforce social skills like Auburn, Lab, or Newton. During the year, Ivymount Outreach runs Unstuck and On Target. The best thing about it is the parent class. Having a SN kid (no matter what the diagnosis) means we need to up our parenting game.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:As a parent, I would do the neuropsych, especially given the early language issues and the wide disparity between verbal and non-verbal ability.

IME with our DS, the neuropsych really teased apart areas where he had widely disparate abilities - 99%ile math reasoning but 30%ile math fluency. He was extremely bright but underlying brain/neuropsych problems like slow processing and word finding difficulty and dysgraphia made doing computations with nevessary speed and accuracy ver difficult.

DS noticed how he could not do things like other kids and he became angry, depressed and anxious. Two years of special instructions, tutors, and self-education about how his brain works has returned our happy optimistic boy to us.

Neuropsych was the key to understanding his strengths and weaknesses. Without it, they just masked each other and he looked like an average kid with mood problems.

Great, thanks. Yes anything that can help us better understand him, and make him more self aware is going to help. Infact I am thinking neuropysch would be as valuable as ADOS if not more.

Our psychologist also mentioned cost as one reason not to got for it, saying it will run into thousands of dollars to tell us what we already know about his anxiety.

Do you mind sharing who you did it with and what was cost? Childrens has atleast a 6 month wait for neuro and 9 months for ADOS.

In general, neuropsych is $3000+.

Your psych's dismissal of this is a red flag to me. Neuropsych provides objective data and rules out other diagnoses (learning disabilities or issues, processing speed or memory problems). Particularly with anxiety, it is important to consider what could be causing the anxiety -- underlying biochemistry? learning differences? speed or memory problems? language issues? Difficulties in all those areas can cause anxiety, and in order to address the anxiety, you would have to address the underlying issues also not just medicate or do therapy.

Check what your insurance might reimburse. If you can't afford it, consider what the school can do. If your child is 10 and was in an IEP, he should have had a full psychological assessment which should have included IQ, full achievement testing, plus language, autism, ADHD and anxiety and depression and a functional behavior assessment. He should have had this when he entered the IEP and before he was moved from the IEP to the 504 plan. Do you have these results? How recent are they? Sometimes schools try to skimp on testing, but legally, they are obliged to do it if you are requesting an IEP and every 3 years on the IEP and if you have a "reasonable suspicion of disability" (i.e. a disorder, adverse educational impact and need for special instruction). Schools skimp by doing just one or two tests or substituting "observation" for actual standardized objective testing.

If the school does the testing (which would be psych only as they typically do not have nueropsych resources), and you disagree with the results you have a right to ask the school system to pay for an IEE (independent educational evaluation) at a provider of your choice. The main difference with the psych assessment and the neuropsych assessment is that the neuropsych typically does additional computer-based or standardized attention and executive function testing, not just behavioral checklists.

OP here, thanks.
I am fine with the 3K, we have high deductible but can pay out of pocket. It was the psychologist who said it is pointless to do as it will cost thousands to learn what we already know.
And for anxiety we did not medicate, but he has not overcome his anxiety either by exposure to the alarm sounds.

Thanks again, it is really hopeful that neuropsych gives more objective assessment than ADOS we have had in the past.

He was just discharged of IEP this year, the school did educational-Kaufman and one other, classroom observation, socio cultural tests in Jan. All seem clear. And yes they did this every 3 years in FCPS, and gave him speech and reading support, and lunch bunch/social skills. Based on education, now he is on grade, so they closed IEP. No ADHD or autism flags, reading on grade. Over and over again he shows higher in non verbal than verbal. We dont have any grounds to dispute them since his only issue (atleast the one he displays) at school is the fire drills and they are providing 504. They are also continuing lunch bunch.

Our main issue is anger/defiance at home. But appears neuropsych can help us help him in areas he is just getting by as well and could possibly be doing much better if we could get to the root cause of his anxiety and anger.

NP. I agree with starting with the neuropsych as I am not sure what a 4th ADOS will tell you. If it comes out positive you will have 2 yes and 2 no...what the heck does that mean? FTR, I have a "spectrumy" language delayed child whose first ADOS was a no, though I don't entirely believe it. I have thought about another but we are already getting him the services we would if he had a diagnosis, so I am saving the money for now. BUT, when we need a psychologist or speech person I make sure they have experience with autism because I think therapists who are educated about autism are better at understanding the impact language/social/sensory difficulties can have and approach their therapy accordingly. Regardless of your child's dx, maybe a therapist who doesn't feel like autism is out of her range of expertise might be better for him, since he does have the history of language delay. Just because someone has training in psychopathology, like anxiety, doesn't mean that they've had any training in developmental issues.

Of course, one reason to consider an ADOS down the road might be to help get school services, but you may be able to do that with your neuropsych. Or if the neuropsychologist says that they really need an ADOS to have a complete picture, then it might be worthwhile to do it.

Also, I wanted to ask if you saw an increase in the behavior problems at home after his IEP was pulled. I am not sure what services he was getting before but where I live it is not uncommon for kids to be exited from services "because they are doing so well" without any thought given to the fact that it is the supports and services that are enabling them to do so well. It is also not uncommon for kids who are struggling in school to keep it together all day but then go home and lose their sh*t. If there really is no rhyme or reason to your son's behavior at home it might be related to anxiety/stress from school.

Thank you! Yes I think the psych's concern is that if he is on spectrum and has communication deficits/rigid tendencies, she might not be very effective.

Regarding IEP, he had behavior outbursts since he was a child, and always only at home. It is less frequency, and it is just that being a tween now he has more intensity. But yes definitely some of these are school triggers, like a kid bullying him or teasing him. The school does take action when they see such behaviors, and the 504 with written support to pull our during fire drills make him calmer. In fact his previous FCPS school was just holding his IEP with emotional disability for last 1-2 years to give him fire drill support, though there was no educational or any underlying emotional need atleast at school.

Majority of his random outbursts are due to defiance and lack of emotional regulation on disappointments.

She already sounds like she's not very effective!

You mention that your child is caught up in language, but there's still a big discrepancy between his verbal and non verbal scores. He also has anxiety and a real aversion to loud noises.

My child with a severe language disorder hated the loud sounds of the fire drill and definitely has anxiety. Language disorders will do that.

I would find someone who can really drill down on the language issues.

Are you familiar with Rick Lavoie? His take on disabilities really opened up my understanding of having a language-based learning disability. The whole FAT City from 1991 is online. It simulated being a learning disabled child in a classroom. He talks about processing about 8:33 in. It's eye-opening how stressful that would be day after day.

https://www.youtube.com/watch?v=hZf8mfQFz-A

[Anonymous]

Anonymous wrote:For people who are astounded by 3 ADOS rounds by age 10 are missing the point that the OP on top of his/her kid's delays. When they're administered to a very young kid, it's pretty basic and involve things like blowing up a balloon. It's not a big deal at all.

The point of doing a neuropsych evaluation is ultimately to determine what educational supports and/or related therapies would help. As a parent, I two would err on the side of doing a full evaluation and not just the ADOS.

A neuropsych can evaluate for autism, but it can also screen for possible additional diagnoses such as...
-- anxiety and/or ADHD which can't be diagnosed by the ADOS alone. If this is the case, you may want to consider medications.
--dyslexia or dysgraphia (which would impact his executive functioning)
Or your kid could end up with a diagnosis of Social Communication Pragmatics Disorder--and while not autism would probably require the same in terms of educational supports.

OP, when you went to KKI did you meet with a developmental pediatrician? Did they flag any motor coordination issues?

And what is she getting out of all of it?

She needs a expert in language disorders.

[Anonymous]

Anonymous wrote:

Anonymous wrote:For people who are astounded by 3 ADOS rounds by age 10 are missing the point that the OP on top of his/her kid's delays. When they're administered to a very young kid, it's pretty basic and involve things like blowing up a balloon. It's not a big deal at all.

The point of doing a neuropsych evaluation is ultimately to determine what educational supports and/or related therapies would help. As a parent, I two would err on the side of doing a full evaluation and not just the ADOS.

A neuropsych can evaluate for autism, but it can also screen for possible additional diagnoses such as...
-- anxiety and/or ADHD which can't be diagnosed by the ADOS alone. If this is the case, you may want to consider medications.
--dyslexia or dysgraphia (which would impact his executive functioning)
Or your kid could end up with a diagnosis of Social Communication Pragmatics Disorder--and while not autism would probably require the same in terms of educational supports.

OP, when you went to KKI did you meet with a developmental pediatrician? Did they flag any motor coordination issues?

And what is she getting out of all of it?

She needs a expert in language disorders.

I don't understand your childish response, PP. Many parents seek out help when our kids have delays and regularly assess our children's needs every few years. We need to be able to inform the IEP team as to what our kids need. The OP diligently sought out help. And the alternative would be? Do nothing?

The OP doesn't need to go to Vanderbilt for an "expert" in language disorders. If it's not a language disorder or autism, it could be quite a few other things. That's why she needs a neuropsychological evaluation.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:For people who are astounded by 3 ADOS rounds by age 10 are missing the point that the OP on top of his/her kid's delays. When they're administered to a very young kid, it's pretty basic and involve things like blowing up a balloon. It's not a big deal at all.

The point of doing a neuropsych evaluation is ultimately to determine what educational supports and/or related therapies would help. As a parent, I two would err on the side of doing a full evaluation and not just the ADOS.

A neuropsych can evaluate for autism, but it can also screen for possible additional diagnoses such as...
-- anxiety and/or ADHD which can't be diagnosed by the ADOS alone. If this is the case, you may want to consider medications.
--dyslexia or dysgraphia (which would impact his executive functioning)
Or your kid could end up with a diagnosis of Social Communication Pragmatics Disorder--and while not autism would probably require the same in terms of educational supports.

OP, when you went to KKI did you meet with a developmental pediatrician? Did they flag any motor coordination issues?

And what is she getting out of all of it?

She needs a expert in language disorders.

I don't understand your childish response, PP. Many parents seek out help when our kids have delays and regularly assess our children's needs every few years. We need to be able to inform the IEP team as to what our kids need. The OP diligently sought out help. And the alternative would be? Do nothing?

The OP doesn't need to go to Vanderbilt for an "expert" in language disorders. If it's not a language disorder or autism, it could be quite a few other things. That's why she needs a neuropsychological evaluation.

Who mentioned Vanderbilt? And it's not "childish" -- it's practical. She's been to evaluators, and they are sending her in circles. Instead of just signing up for another evaluation, she needs to find an expert that can target her child's issues. It means doing a lot of homework before you walk through the doctor's door.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:For people who are astounded by 3 ADOS rounds by age 10 are missing the point that the OP on top of his/her kid's delays. When they're administered to a very young kid, it's pretty basic and involve things like blowing up a balloon. It's not a big deal at all.

The point of doing a neuropsych evaluation is ultimately to determine what educational supports and/or related therapies would help. As a parent, I two would err on the side of doing a full evaluation and not just the ADOS.

A neuropsych can evaluate for autism, but it can also screen for possible additional diagnoses such as...
-- anxiety and/or ADHD which can't be diagnosed by the ADOS alone. If this is the case, you may want to consider medications.
--dyslexia or dysgraphia (which would impact his executive functioning)
Or your kid could end up with a diagnosis of Social Communication Pragmatics Disorder--and while not autism would probably require the same in terms of educational supports.

OP, when you went to KKI did you meet with a developmental pediatrician? Did they flag any motor coordination issues?

And what is she getting out of all of it?

She needs a expert in language disorders.

I don't understand your childish response, PP. Many parents seek out help when our kids have delays and regularly assess our children's needs every few years. We need to be able to inform the IEP team as to what our kids need. The OP diligently sought out help. And the alternative would be? Do nothing?

The OP doesn't need to go to Vanderbilt for an "expert" in language disorders. If it's not a language disorder or autism, it could be quite a few other things. That's why she needs a neuropsychological evaluation.

Who mentioned Vanderbilt? And it's not "childish" -- it's practical. She's been to evaluators, and they are sending her in circles. Instead of just signing up for another evaluation, she needs to find an expert that can target her child's issues. It means doing a lot of homework before you walk through the doctor's door.

I'm a PP but not the PP. Those issues would be? Multiple ADOSes does not = multiple neuropsychs. Often on this board I think people jump too quickly to recommend a neuropsych evaluation. It is not always necessary. In this case, it is. Maybe after that a language expert would be important, but I think a neuropsych is a better place to start because it sounds like there are other things in addition to language.

And Vanderbilt came up, I assume, because PP assumed that "Camarata" would be the next recommendation.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:For people who are astounded by 3 ADOS rounds by age 10 are missing the point that the OP on top of his/her kid's delays. When they're administered to a very young kid, it's pretty basic and involve things like blowing up a balloon. It's not a big deal at all.

The point of doing a neuropsych evaluation is ultimately to determine what educational supports and/or related therapies would help. As a parent, I two would err on the side of doing a full evaluation and not just the ADOS.

A neuropsych can evaluate for autism, but it can also screen for possible additional diagnoses such as...
-- anxiety and/or ADHD which can't be diagnosed by the ADOS alone. If this is the case, you may want to consider medications.
--dyslexia or dysgraphia (which would impact his executive functioning)
Or your kid could end up with a diagnosis of Social Communication Pragmatics Disorder--and while not autism would probably require the same in terms of educational supports.

OP, when you went to KKI did you meet with a developmental pediatrician? Did they flag any motor coordination issues?

And what is she getting out of all of it?

She needs a expert in language disorders.

I don't understand your childish response, PP. Many parents seek out help when our kids have delays and regularly assess our children's needs every few years. We need to be able to inform the IEP team as to what our kids need. The OP diligently sought out help. And the alternative would be? Do nothing?

The OP doesn't need to go to Vanderbilt for an "expert" in language disorders. If it's not a language disorder or autism, it could be quite a few other things. That's why she needs a neuropsychological evaluation.

Who mentioned Vanderbilt? And it's not "childish" -- it's practical. She's been to evaluators, and they are sending her in circles. Instead of just signing up for another evaluation, she needs to find an expert that can target her child's issues. It means doing a lot of homework before you walk through the doctor's door.

I'm a PP but not the PP. Those issues would be? Multiple ADOSes does not = multiple neuropsychs. Often on this board I think people jump too quickly to recommend a neuropsych evaluation. It is not always necessary. In this case, it is. Maybe after that a language expert would be important, but I think a neuropsych is a better place to start because it sounds like there are other things in addition to language.

And Vanderbilt came up, I assume, because PP assumed that "Camarata" would be the next recommendation.

I am the PP, and I did take all the ADOS testing to mean she had also already had at least one neuropsych done.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:For people who are astounded by 3 ADOS rounds by age 10 are missing the point that the OP on top of his/her kid's delays. When they're administered to a very young kid, it's pretty basic and involve things like blowing up a balloon. It's not a big deal at all.

The point of doing a neuropsych evaluation is ultimately to determine what educational supports and/or related therapies would help. As a parent, I two would err on the side of doing a full evaluation and not just the ADOS.

A neuropsych can evaluate for autism, but it can also screen for possible additional diagnoses such as...
-- anxiety and/or ADHD which can't be diagnosed by the ADOS alone. If this is the case, you may want to consider medications.
--dyslexia or dysgraphia (which would impact his executive functioning)
Or your kid could end up with a diagnosis of Social Communication Pragmatics Disorder--and while not autism would probably require the same in terms of educational supports.

OP, when you went to KKI did you meet with a developmental pediatrician? Did they flag any motor coordination issues?

And what is she getting out of all of it?

She needs a expert in language disorders.

I don't understand your childish response, PP. Many parents seek out help when our kids have delays and regularly assess our children's needs every few years. We need to be able to inform the IEP team as to what our kids need. The OP diligently sought out help. And the alternative would be? Do nothing?

The OP doesn't need to go to Vanderbilt for an "expert" in language disorders. If it's not a language disorder or autism, it could be quite a few other things. That's why she needs a neuropsychological evaluation.

Who mentioned Vanderbilt? And it's not "childish" -- it's practical. She's been to evaluators, and they are sending her in circles. Instead of just signing up for another evaluation, she needs to find an expert that can target her child's issues. It means doing a lot of homework before you walk through the doctor's door.

I'm a PP but not the PP. Those issues would be? Multiple ADOSes does not = multiple neuropsychs. Often on this board I think people jump too quickly to recommend a neuropsych evaluation. It is not always necessary. In this case, it is. Maybe after that a language expert would be important, but I think a neuropsych is a better place to start because it sounds like there are other things in addition to language.

And Vanderbilt came up, I assume, because PP assumed that "Camarata" would be the next recommendation.

I am the PP, and I did take all the ADOS testing to mean she had also already had at least one neuropsych done.

Nope. A toddler can have the ADOS testing. Please name a local "language disorder expert." The only name that consistently comes up on this forum is Camarata.

[Anonymous]

There is no more value in a neuropsych nor is going to the Camarata's. At this point, the identified issues are behavior and anxiety. Language may play a part if he still struggles a little with expressive and the current psychologist may not understand the nuances with a child with a previous language disorder. If the child is testing in the below average range, no school will provide IEP/speech services. At some point, kids need to learn to adapt and getting speech therapy isn't going to be that helpful at that age. The Camarata's do not do mental health/behavioral issues. They can still say if it is a language issue, but that's it.

Personally, I'd try other therapists and try to find one that better connects and talk to a psychiatrist about trying an anxiety medication. Someone needs to figure out how to connect with this child and try to figure out what is behind the behavioral issues, especially when they are mainly at home. Do individual and family counseling and approach it as a family issue and how can everyone make changes to make things happier and easier for the child.

I would get a hearing test and see if an audiologist can pinpoint why the fire drills are so unnerving to him (I would suspect its more anxiety but rule out hearing issues). Most kids outgrow that by 4-5-6 so given it continues at 10, there is more to what is going on.

It doesn't matter if it is autism at this point. There is nothing that they can do for autism now, especially when the main stuff is at home. Some kids also regardless of past history test limits again at this age and are trying to figure out the world and where they fit in. I wouldn't ignore it, but I wouldn't run and worry about multiple evaluations which can cause more anxiety but rather look at the problem, try to find the root and more importantly, how to make things better for the child.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:For people who are astounded by 3 ADOS rounds by age 10 are missing the point that the OP on top of his/her kid's delays. When they're administered to a very young kid, it's pretty basic and involve things like blowing up a balloon. It's not a big deal at all.

The point of doing a neuropsych evaluation is ultimately to determine what educational supports and/or related therapies would help. As a parent, I two would err on the side of doing a full evaluation and not just the ADOS.

A neuropsych can evaluate for autism, but it can also screen for possible additional diagnoses such as...
-- anxiety and/or ADHD which can't be diagnosed by the ADOS alone. If this is the case, you may want to consider medications.
--dyslexia or dysgraphia (which would impact his executive functioning)
Or your kid could end up with a diagnosis of Social Communication Pragmatics Disorder--and while not autism would probably require the same in terms of educational supports.

OP, when you went to KKI did you meet with a developmental pediatrician? Did they flag any motor coordination issues?

And what is she getting out of all of it?

She needs a expert in language disorders.

I don't understand your childish response, PP. Many parents seek out help when our kids have delays and regularly assess our children's needs every few years. We need to be able to inform the IEP team as to what our kids need. The OP diligently sought out help. And the alternative would be? Do nothing?

The OP doesn't need to go to Vanderbilt for an "expert" in language disorders. If it's not a language disorder or autism, it could be quite a few other things. That's why she needs a neuropsychological evaluation.

Who mentioned Vanderbilt? And it's not "childish" -- it's practical. She's been to evaluators, and they are sending her in circles. Instead of just signing up for another evaluation, she needs to find an expert that can target her child's issues. It means doing a lot of homework before you walk through the doctor's door.

I'm a PP but not the PP. Those issues would be? Multiple ADOSes does not = multiple neuropsychs. Often on this board I think people jump too quickly to recommend a neuropsych evaluation. It is not always necessary. In this case, it is. Maybe after that a language expert would be important, but I think a neuropsych is a better place to start because it sounds like there are other things in addition to language.

And Vanderbilt came up, I assume, because PP assumed that "Camarata" would be the next recommendation.

I am the PP, and I did take all the ADOS testing to mean she had also already had at least one neuropsych done.

Nope. A toddler can have the ADOS testing. Please name a local "language disorder expert." The only name that consistently comes up on this forum is Camarata.

This isn't about a toddler nor is this really about a language disorder. The Camarata's are the leading experts. There are a few good private providers but that is subjective. Ours is great and really understands our child but is no longer doing this type of therapy. If anything, I'd go to Maryland or a clinic and get a new language evaluation but at this point, there probably isn't much speech therapy can do and the behaviors are mainly at home, which means there are triggers at home (or no triggers and it is just a safe place for child to figure it all out) and getting a good (which is easier said than done) therapist to help everyone figure that out and make changes would be more important. Child also needs to be evaluated to see if anxiety medication would be helpful. He probably should also be evaluated for depression given depression looks very different in kids and acting out is one of the signs.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:For people who are astounded by 3 ADOS rounds by age 10 are missing the point that the OP on top of his/her kid's delays. When they're administered to a very young kid, it's pretty basic and involve things like blowing up a balloon. It's not a big deal at all.

The point of doing a neuropsych evaluation is ultimately to determine what educational supports and/or related therapies would help. As a parent, I two would err on the side of doing a full evaluation and not just the ADOS.

A neuropsych can evaluate for autism, but it can also screen for possible additional diagnoses such as...
-- anxiety and/or ADHD which can't be diagnosed by the ADOS alone. If this is the case, you may want to consider medications.
--dyslexia or dysgraphia (which would impact his executive functioning)
Or your kid could end up with a diagnosis of Social Communication Pragmatics Disorder--and while not autism would probably require the same in terms of educational supports.

OP, when you went to KKI did you meet with a developmental pediatrician? Did they flag any motor coordination issues?

And what is she getting out of all of it?

She needs a expert in language disorders.

I don't understand your childish response, PP. Many parents seek out help when our kids have delays and regularly assess our children's needs every few years. We need to be able to inform the IEP team as to what our kids need. The OP diligently sought out help. And the alternative would be? Do nothing?

The OP doesn't need to go to Vanderbilt for an "expert" in language disorders. If it's not a language disorder or autism, it could be quite a few other things. That's why she needs a neuropsychological evaluation.

Who mentioned Vanderbilt? And it's not "childish" -- it's practical. She's been to evaluators, and they are sending her in circles. Instead of just signing up for another evaluation, she needs to find an expert that can target her child's issues. It means doing a lot of homework before you walk through the doctor's door.

I'm a PP but not the PP. Those issues would be? Multiple ADOSes does not = multiple neuropsychs. Often on this board I think people jump too quickly to recommend a neuropsych evaluation. It is not always necessary. In this case, it is. Maybe after that a language expert would be important, but I think a neuropsych is a better place to start because it sounds like there are other things in addition to language.

And Vanderbilt came up, I assume, because PP assumed that "Camarata" would be the next recommendation.

I am the PP, and I did take all the ADOS testing to mean she had also already had at least one neuropsych done.

Nope. A toddler can have the ADOS testing. Please name a local "language disorder expert." The only name that consistently comes up on this forum is Camarata.

This isn't about a toddler nor is this really about a language disorder. The Camarata's are the leading experts. There are a few good private providers but that is subjective. Ours is great and really understands our child but is no longer doing this type of therapy. If anything, I'd go to Maryland or a clinic and get a new language evaluation but at this point, there probably isn't much speech therapy can do and the behaviors are mainly at home, which means there are triggers at home (or no triggers and it is just a safe place for child to figure it all out) and getting a good (which is easier said than done) therapist to help everyone figure that out and make changes would be more important. Child also needs to be evaluated to see if anxiety medication would be helpful. He probably should also be evaluated for depression given depression looks very different in kids and acting out is one of the signs.

No kidding it's not about a toddler. People need to understand that ADOS can be administered multiple times at multiple ages. Because it's called a SPECTRUM. For some children the signs are very apparent at a very young age. For others there may be some indications of autism and that's why the results may be inconclusive.

It's not chasing your tail. This OP has logically followed what his/her kid's delays were. This kid got ST and an IEP. The OP's doing a great parenting job and is at a crossroad.

It doesn't matter if the Camaratas are "the" experts or not. People recommend seeing a language disorder expert and their names are the only one that comes up. So if no one actually has a different suggestion, just say what you mean. The main issues are obviously with behavior, so if a ST can't help with this, stop suggesting this.

Lastly, a neuropsychological evaluation CAN assess for anxiety. But it can also give a differential diagnosis. You don't want to medicate a child for something they don't have. Also, many of us do testing for our kids every few years. It's not necessarily a one and done affair. It's expensive but it helps navigating/planning for the future--correcting the course.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:For people who are astounded by 3 ADOS rounds by age 10 are missing the point that the OP on top of his/her kid's delays. When they're administered to a very young kid, it's pretty basic and involve things like blowing up a balloon. It's not a big deal at all.

The point of doing a neuropsych evaluation is ultimately to determine what educational supports and/or related therapies would help. As a parent, I two would err on the side of doing a full evaluation and not just the ADOS.

A neuropsych can evaluate for autism, but it can also screen for possible additional diagnoses such as...
-- anxiety and/or ADHD which can't be diagnosed by the ADOS alone. If this is the case, you may want to consider medications.
--dyslexia or dysgraphia (which would impact his executive functioning)
Or your kid could end up with a diagnosis of Social Communication Pragmatics Disorder--and while not autism would probably require the same in terms of educational supports.

OP, when you went to KKI did you meet with a developmental pediatrician? Did they flag any motor coordination issues?

And what is she getting out of all of it?

She needs a expert in language disorders.

I don't understand your childish response, PP. Many parents seek out help when our kids have delays and regularly assess our children's needs every few years. We need to be able to inform the IEP team as to what our kids need. The OP diligently sought out help. And the alternative would be? Do nothing?

The OP doesn't need to go to Vanderbilt for an "expert" in language disorders. If it's not a language disorder or autism, it could be quite a few other things. That's why she needs a neuropsychological evaluation.

Who mentioned Vanderbilt? And it's not "childish" -- it's practical. She's been to evaluators, and they are sending her in circles. Instead of just signing up for another evaluation, she needs to find an expert that can target her child's issues. It means doing a lot of homework before you walk through the doctor's door.

I'm a PP but not the PP. Those issues would be? Multiple ADOSes does not = multiple neuropsychs. Often on this board I think people jump too quickly to recommend a neuropsych evaluation. It is not always necessary. In this case, it is. Maybe after that a language expert would be important, but I think a neuropsych is a better place to start because it sounds like there are other things in addition to language.

And Vanderbilt came up, I assume, because PP assumed that "Camarata" would be the next recommendation.

I am the PP, and I did take all the ADOS testing to mean she had also already had at least one neuropsych done.

Nope. A toddler can have the ADOS testing. Please name a local "language disorder expert." The only name that consistently comes up on this forum is Camarata.

This isn't about a toddler nor is this really about a language disorder. The Camarata's are the leading experts. There are a few good private providers but that is subjective. Ours is great and really understands our child but is no longer doing this type of therapy. If anything, I'd go to Maryland or a clinic and get a new language evaluation but at this point, there probably isn't much speech therapy can do and the behaviors are mainly at home, which means there are triggers at home (or no triggers and it is just a safe place for child to figure it all out) and getting a good (which is easier said than done) therapist to help everyone figure that out and make changes would be more important. Child also needs to be evaluated to see if anxiety medication would be helpful. He probably should also be evaluated for depression given depression looks very different in kids and acting out is one of the signs.

No kidding it's not about a toddler. People need to understand that ADOS can be administered multiple times at multiple ages. Because it's called a SPECTRUM. For some children the signs are very apparent at a very young age. For others there may be some indications of autism and that's why the results may be inconclusive.

It's not chasing your tail. This OP has logically followed what his/her kid's delays were. This kid got ST and an IEP. The OP's doing a great parenting job and is at a crossroad.

It doesn't matter if the Camaratas are "the" experts or not. People recommend seeing a language disorder expert and their names are the only one that comes up. So if no one actually has a different suggestion, just say what you mean. The main issues are obviously with behavior, so if a ST can't help with this, stop suggesting this.

Lastly, a neuropsychological evaluation CAN assess for anxiety. But it can also give a differential diagnosis. You don't want to medicate a child for something they don't have. Also, many of us do testing for our kids every few years. It's not necessarily a one and done affair. It's expensive but it helps navigating/planning for the future--correcting the course.

Your only viewpoint in every post on topic is assuming every child is"autism" and needing a neuropsych or diagnosis. At this point, what good will it do? Child needs a real mental health exam, not just a generalist looking at everything. I never suggested the child get ST. You are confusing posters. I think its a waste of time as is a neuropsych and autism diagnosis. Child is having behavioral issues at home.

[Anonymous]

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Anonymous wrote:For people who are astounded by 3 ADOS rounds by age 10 are missing the point that the OP on top of his/her kid's delays. When they're administered to a very young kid, it's pretty basic and involve things like blowing up a balloon. It's not a big deal at all.

The point of doing a neuropsych evaluation is ultimately to determine what educational supports and/or related therapies would help. As a parent, I two would err on the side of doing a full evaluation and not just the ADOS.

A neuropsych can evaluate for autism, but it can also screen for possible additional diagnoses such as...
-- anxiety and/or ADHD which can't be diagnosed by the ADOS alone. If this is the case, you may want to consider medications.
--dyslexia or dysgraphia (which would impact his executive functioning)
Or your kid could end up with a diagnosis of Social Communication Pragmatics Disorder--and while not autism would probably require the same in terms of educational supports.

OP, when you went to KKI did you meet with a developmental pediatrician? Did they flag any motor coordination issues?

And what is she getting out of all of it?

She needs a expert in language disorders.

I don't understand your childish response, PP. Many parents seek out help when our kids have delays and regularly assess our children's needs every few years. We need to be able to inform the IEP team as to what our kids need. The OP diligently sought out help. And the alternative would be? Do nothing?

The OP doesn't need to go to Vanderbilt for an "expert" in language disorders. If it's not a language disorder or autism, it could be quite a few other things. That's why she needs a neuropsychological evaluation.

Who mentioned Vanderbilt? And it's not "childish" -- it's practical. She's been to evaluators, and they are sending her in circles. Instead of just signing up for another evaluation, she needs to find an expert that can target her child's issues. It means doing a lot of homework before you walk through the doctor's door.

I'm a PP but not the PP. Those issues would be? Multiple ADOSes does not = multiple neuropsychs. Often on this board I think people jump too quickly to recommend a neuropsych evaluation. It is not always necessary. In this case, it is. Maybe after that a language expert would be important, but I think a neuropsych is a better place to start because it sounds like there are other things in addition to language.

And Vanderbilt came up, I assume, because PP assumed that "Camarata" would be the next recommendation.

I am the PP, and I did take all the ADOS testing to mean she had also already had at least one neuropsych done.

Nope. A toddler can have the ADOS testing. Please name a local "language disorder expert." The only name that consistently comes up on this forum is Camarata.

This isn't about a toddler nor is this really about a language disorder. The Camarata's are the leading experts. There are a few good private providers but that is subjective. Ours is great and really understands our child but is no longer doing this type of therapy. If anything, I'd go to Maryland or a clinic and get a new language evaluation but at this point, there probably isn't much speech therapy can do and the behaviors are mainly at home, which means there are triggers at home (or no triggers and it is just a safe place for child to figure it all out) and getting a good (which is easier said than done) therapist to help everyone figure that out and make changes would be more important. Child also needs to be evaluated to see if anxiety medication would be helpful. He probably should also be evaluated for depression given depression looks very different in kids and acting out is one of the signs.

No kidding it's not about a toddler. People need to understand that ADOS can be administered multiple times at multiple ages. Because it's called a SPECTRUM. For some children the signs are very apparent at a very young age. For others there may be some indications of autism and that's why the results may be inconclusive.

It's not chasing your tail. This OP has logically followed what his/her kid's delays were. This kid got ST and an IEP. The OP's doing a great parenting job and is at a crossroad.

It doesn't matter if the Camaratas are "the" experts or not. People recommend seeing a language disorder expert and their names are the only one that comes up. So if no one actually has a different suggestion, just say what you mean. The main issues are obviously with behavior, so if a ST can't help with this, stop suggesting this.

Lastly, a neuropsychological evaluation CAN assess for anxiety. But it can also give a differential diagnosis. You don't want to medicate a child for something they don't have. Also, many of us do testing for our kids every few years. It's not necessarily a one and done affair. It's expensive but it helps navigating/planning for the future--correcting the course.

Your only viewpoint in every post on topic is assuming every child is"autism" and needing a neuropsych or diagnosis. At this point, what good will it do? Child needs a real mental health exam, not just a generalist looking at everything. I never suggested the child get ST. You are confusing posters. I think its a waste of time as is a neuropsych and autism diagnosis. Child is having behavioral issues at home.

PP, nice attempt at trying to divert the topic and applying alternative facts. Read the whole post that you're quoting. I don't know if the OP's child has autism or not. The point of a neurospych eval are many as STATED ABOVE:

-- anxiety and/or ADHD which can't be diagnosed by the ADOS alone. If this is the case, you may want to consider medications.
--dyslexia or dysgraphia (which would impact his executive functioning)
Or your kid could end up with a diagnosis of Social Communication Pragmatics Disorder--and while not autism would probably require the same in terms of educational supports.

If a child is having behavioral issues at home there are lots of things to be done regardless of the diagnosis. You really don't know what a this testing does or what a "mental health exam" would look like for a 10 year old.

[Anonymous]

The child is not having issues at school. The child has had multiple evaluations and therapy. At this point, one would have found the other issues. OP identified Anxiety and behavioral issues. You didn't read the original post and are making it into your one size fit all. Yes, I do know what a mental health exam looks like for a child. That is exactly why I am saying the child needs one. You are only suggesting a few things to look at. You are too busy pushing your agenda and it makes no sense.