ADHD, not autism -- what now?

[Anonymous]

Hi all. When my DD was 2 1/2 years old, she was diagnosed with "moderate to severe autism." It was a huge blow, and a very difficult time for us. We had some doubts about the diagnosis, but thought it was best to just move forward and get her services (PRT, OT, some floortime) -- which we did. And she responded very well, and got better and better, and more and more social.... So, we had her reassessed by Kennedy Kreiger when she hit age 3 last week -- and the diagnoses was ADHD, with sensory issues and anxiety (along with Dysarthria and speech delays). The doctor did not think she had autism, as she had no restrictive/repetitive interests and she was just too social.

We're obviously thrilled and relieved. But, all our focus has been on autism to this point, so we're a little lost as to what to do now.

- Can you get an IEP for ADHD + speech delays (receptive and expressive) -- I'm assuming yes.
- The doctor recommended a "special eduction preschool with speech and OT, and special instruction." What exactly does that mean, she should be in a school just for ADHD/special needs, and not in a full inclusion school (with pullout, etc.)? for ADHD, really? We were fortunate to get into Creative Minds for PS3, which we had heard was great for special needs/autism -- i assume it will work well for ASD too.
- What federal insurance in DC is good for ADHD therapies, particularly Speech and OT? We had been pretty focused on finding best insurance for ABA treatment for autism, which obviously isn't a priority now.

I know she is still very young and we will need to monitor closely and should focus on the symptoms, not the label -- which we are trying to do. I also know that ADHD is no picnic, and our DD will have struggles, etc. But we admittedly are happy and relieved as her long term prognosis seems much more positive now....

Thanks in advance for your feedback!

[Anonymous]

We're going through the process of getting our son into the County special ed preschool program. Once he is found eligible, he can receive services ranging from speech therapy to OT while he is there. The program is 1/2 day, 2-5 days a week depending on what your child needs. Have you begun this process at all? Is your child in Early Intervention? If your child is in EI, then they transition to the County services regularly, and can definitely guide you on how the process works.

I'm curious...what made you get a second opinion? Your situation is interesting to me because my son was dxed with ASD just after he turned 2...and was said to be mild....I think mostly because he doesn't exhibit many of the classic autism behaviors. He is VERY smiley with both my husband and I, as well as others....doesn't exhibit repetitive behaviors like lining up objects etc. He is not what I'd call a social butterfly, but he tolerates a traditional daycare with many children in his class. He is extremely hyper...and we've always wondered about the ADHD component.

[Anonymous]

You will probably get better and more complete answers if you post your school system.

My son, whose diagnoses are/were similar to that of your daughter has had an IEP since he was eligible. In Infants and Toddlers, he got education, speech, OT and some other cognitive therapy. When he hit age 3, he was dropped back to only speech. At some point, maybe second or third grade, he dropped the speech diagnosis and his IEP switched to an OHI diagnosis - Other Health Impairment. OHI can include ADHD and anxiety, PTSD and other health conditions. PTSD and anxiety can also qualify your child for an ED classification, but in my son's case his issues are not behavioral, so he was given the OHI classification. Just has his requalifying IEP (getting ready for middle school). With the IEP, he gets supports and services.

As far as OT, he never requalified for OT once he hit age 3 and he was evaluated several times because the school thought he should qualify. We did get a classroom evaluation and some adaptive equipment, like a seat cushion. But that was it.

So, I guess the short answer is you can get an IEP and services. I am not familiar with the preschool options.

[Anonymous]

OP is in DC.

OP, you should talk to Creative Minds about your concerns and your daughter's issues. Have you accepted yet? Do they know about the SNs? Legally they have to provide whatever she needs and charters get extra funding for IEPs. I hear CM had a lot of kids on IEPs just in regular classes with supports. Second hand though.

[Anonymous]

Curious- what made you all seek therapy for your children when they were so young? 13:12- you mention that your son had an IEP as an infant. What signs did you notice that alerted you to the need for a diagnosis?

[Anonymous]

13:28 My son was referred for a pediatric developmental eval. after he failed the MCHAT questionnaire at his 18 month well baby exam. At the time, he was non-verbal and did not turn to us when his name was called. He started speech therapy services with Early Intervention at 19 months, and by 20 months, he started side glancing/visual stimming. At 24 months, he was still non verbal and in addition to the other things I mentioned, we started to see the non-social component emerge at the daycare, so we had him tested. He was diagnosed with mild ASD and a strong likelihood to develop ADHD at just 24 months.

[Anonymous]

With respect to federal insurance covering therapies, you should go online and really read the brochures carefully once you know what you'll need. Next open season isn't for a while. For example, in the BC/BS PPO plans, basic covers 50 OT sessions ($20 copay) whereas standard covers 75. To make the decision about what will work best for your family, you also need to contemplate in-network and out.

[Anonymous]

OP, the reason why he likely recommended special education preschool is because KKI is in MD, and that's the model they use. The public schools in MD start at Kindergarten, and the majority of children in public preschools are in programs specifically designed for children with disabilities. Even the inclusive classrooms, which have a mix of children with disabilities and children without disabilities are considered special education preschool.

DC in general, and CM in particular use a different model. Because DC funds preschool for large numbers of preschoolers there are plenty of classes in which students with disabilities can be placed, and so the majority of children can be placed in inclusive classrooms where the majority of their classmates are students without disabilities.

CM has a good reputation for serving students with disabilities. Although they talk a lot about serving kids with autism, many of the things that a child with ADHD and a speech delay needs are the same as what a student with autism needs. A warm supportive classroom with clear structures and teachers who know how to develop the skills of children with disabilities, a speech pathologist for individual or small group therapy, and attention to sensory aspects of the environment are examples of needs the two groups share. You are lucky to have gotten a place there. I would expect that your daughter will continue to make progress and thrive.

[Anonymous]

Agree with 21:06 there probably won't be a lot of difference in terms of therapy at this age.

[Anonymous]

Anonymous wrote:We're going through the process of getting our son into the County special ed preschool program. Once he is found eligible, he can receive services ranging from speech therapy to OT while he is there. The program is 1/2 day, 2-5 days a week depending on what your child needs. Have you begun this process at all? Is your child in Early Intervention? If your child is in EI, then they transition to the County services regularly, and can definitely guide you on how the process works.

I'm curious...what made you get a second opinion? Your situation is interesting to me because my son was dxed with ASD just after he turned 2...and was said to be mild....I think mostly because he doesn't exhibit many of the classic autism behaviors. He is VERY smiley with both my husband and I, as well as others....doesn't exhibit repetitive behaviors like lining up objects etc. He is not what I'd call a social butterfly, but he tolerates a traditional daycare with many children in his class. He is extremely hyper...and we've always wondered about the ADHD component.

ASD can be accompanied by ADHD.

[Anonymous]

Anonymous wrote:Agree with 21:06 there probably won't be a lot of difference in terms of therapy at this age.

I agree. Our older 3 was diagnosed ADHD -- passed every ASD screening and we've had a complete evaluation more than once. At this age, with HFA or just ADHD, you will need very similar services.

[Anonymous]

KKI also diagnosed my DC with ADHD, not autism.

She has autism.

[Anonymous]

Anonymous wrote:Hi all. When my DD was 2 1/2 years old, she was diagnosed with "moderate to severe autism." It was a huge blow, and a very difficult time for us. We had some doubts about the diagnosis, but thought it was best to just move forward and get her services (PRT, OT, some floortime) -- which we did. And she responded very well, and got better and better, and more and more social.... So, we had her reassessed by Kennedy Kreiger when she hit age 3 last week -- and the diagnoses was ADHD, with sensory issues and anxiety (along with Dysarthria and speech delays). The doctor did not think she had autism, as she had no restrictive/repetitive interests and she was just too social.

We're obviously thrilled and relieved. But, all our focus has been on autism to this point, so we're a little lost as to what to do now.

- Can you get an IEP for ADHD + speech delays (receptive and expressive) -- I'm assuming yes.
- The doctor recommended a "special eduction preschool with speech and OT, and special instruction." What exactly does that mean, she should be in a school just for ADHD/special needs, and not in a full inclusion school (with pullout, etc.)? for ADHD, really? We were fortunate to get into Creative Minds for PS3, which we had heard was great for special needs/autism -- i assume it will work well for ASD too.
- What federal insurance in DC is good for ADHD therapies, particularly Speech and OT? We had been pretty focused on finding best insurance for ABA treatment for autism, which obviously isn't a priority now.

I know she is still very young and we will need to monitor closely and should focus on the symptoms, not the label -- which we are trying to do. I also know that ADHD is no picnic, and our DD will have struggles, etc. But we admittedly are happy and relieved as her long term prognosis seems much more positive now....

Thanks in advance for your feedback!

My DC has an IEP just for receptive/expressive language delays. Kids get IEPs for ADHD all the time.

[Anonymous]

Anonymous wrote:Hi all. When my DD was 2 1/2 years old, she was diagnosed with "moderate to severe autism." It was a huge blow, and a very difficult time for us. We had some doubts about the diagnosis, but thought it was best to just move forward and get her services (PRT, OT, some floortime) -- which we did. And she responded very well, and got better and better, and more and more social.... So, we had her reassessed by Kennedy Kreiger when she hit age 3 last week -- and the diagnoses was ADHD, with sensory issues and anxiety (along with Dysarthria and speech delays). The doctor did not think she had autism, as she had no restrictive/repetitive interests and she was just too social.

We're obviously thrilled and relieved. But, all our focus has been on autism to this point, so we're a little lost as to what to do now.

- Can you get an IEP for ADHD + speech delays (receptive and expressive) -- I'm assuming yes.
- The doctor recommended a "special eduction preschool with speech and OT, and special instruction." What exactly does that mean, she should be in a school just for ADHD/special needs, and not in a full inclusion school (with pullout, etc.)? for ADHD, really? We were fortunate to get into Creative Minds for PS3, which we had heard was great for special needs/autism -- i assume it will work well for ASD too.
- What federal insurance in DC is good for ADHD therapies, particularly Speech and OT? We had been pretty focused on finding best insurance for ABA treatment for autism, which obviously isn't a priority now.

I know she is still very young and we will need to monitor closely and should focus on the symptoms, not the label -- which we are trying to do. I also know that ADHD is no picnic, and our DD will have struggles, etc. But we admittedly are happy and relieved as her long term prognosis seems much more positive now....

Thanks in advance for your feedback!

FYI, autism diagnoses before age 3 are wrong 60 percent of the time or more.

Moderate to severe autism should be pretty unmistakable, though. Seems like your first doctor really blew it.

You are right to treat all the symptoms and keep moving forward. Good luck!

[Anonymous]

Anonymous wrote:

Anonymous wrote:We're going through the process of getting our son into the County special ed preschool program. Once he is found eligible, he can receive services ranging from speech therapy to OT while he is there. The program is 1/2 day, 2-5 days a week depending on what your child needs. Have you begun this process at all? Is your child in Early Intervention? If your child is in EI, then they transition to the County services regularly, and can definitely guide you on how the process works.

I'm curious...what made you get a second opinion? Your situation is interesting to me because my son was dxed with ASD just after he turned 2...and was said to be mild....I think mostly because he doesn't exhibit many of the classic autism behaviors. He is VERY smiley with both my husband and I, as well as others....doesn't exhibit repetitive behaviors like lining up objects etc. He is not what I'd call a social butterfly, but he tolerates a traditional daycare with many children in his class. He is extremely hyper...and we've always wondered about the ADHD component.

ASD can be accompanied by ADHD.

Absolutely. DC has been diagnosed as both. The first five rounds of testing (DC is now an adult) indicated ADHD/Exec. functioning etc. We didn't get the final HFA diagnosis until @ five years ago and only after I insisted on blind testing, meaning the testers could not see what prior testers had found. A lot of testers don't know what they are doing. I'm also been very disappointed with our psychiatrist. After first year in college, we switched and are hopeful the new psychiatrist and meds work. It's been a long, long process and we've consulted a lot of "specialists". There are too many nuts in the field, unfortunately, so it is difficult to get a correct diagnosis and then proper help. Good luck to you.