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

[Anonymous]

Anonymous wrote:

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?

Not necessarily. The evaluation is only as good as the psychologist. Two kids in same school YEARS apart evaluated by two different psychologists, one came out brilliant but with "slow processing speed" the other came out dumb as a rock with a "specific learning disability" in math. We knew about the LD, but did not agree re intelligence.

For the second kid, we were very upset, and our ped recommended a full neuropsych evaluation at KK - we also got on their waitlist, and they did an amazing job. While child does have visual motor problems which are causing a "specific learning disability in math" which is so specific they did not identify it? The kid has math issues, but her other scores were no longer "average, average, average" but rather >99.9th percentile and they clocked her in 2nd grade reading (and comprehending) at a 5th grade level. THIS was the child we knew. So be careful if you let the school do an initial IQ test. They also picked up on how her fine motor delays (the school gives her OT 2x a week) affect performance scores on IQ tests, which were on the WISC (which they could not redo - couldn't redo any of the tests the school had done) "below average", which the school psychologist did not. Terrible Terrible Terrible report and Terrible testing.

KK did focus a lot on her fidgeting and potential ADHD (I guess it is in vogue) but our survey and the teacher survey did not confirm it so they had to drop it. Anyway, I would do private neuropsych testing if your insurance will pay for it and if your kid is old enough so that makes sense before letting the school have access to test your child or the results............. we expected sort of stratosphere and below zero results, we did not expect average average average which can be 39th% or 89th% and sentences like with such a score, child should be able to master.....

As opposed to, a score in the 99th percentile shows that this is one of child's strong points, and she can use it to compensate for........... Completely different scores, completely different tones, completely different results..........

[Anonymous]

Anonymous wrote:Childfind definitely does NOT over-diagnose. If anything, I think they totally underdiagnose. They found nothing for my kid (although the evaluators all told me off book that he plainly had issues) because he could pass all the little tests, even though he was bending over backwards (literally!) to do them.

I think the preschool teachers are probably the best situated person to observe a problem (because often problems only show up in a group, and not when you are one on one with you child) ...but if what the teacher is saying does not resonate in any way with your own experience or what other adults (relatives, coaches, previous teachers) have observed, then I would be very concerned that it is some dynamic in the classroom that is causing the problem.

Childfind doesn't actually "diagnose." You are qualifying for services b/c the delays your child is having meet a certain threshold and has an "educational impact."

Early Intervention also doesn't diagnose. You are qualifying for services by meeting a certain percentage of delays.

Either way, your kid can have delays not acknowledged by Childfind or EI.

[Anonymous]

I agree that the evaluation is only as good as the person doing it. I have paid for testing that was incredibly poorly executed.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Childfind definitely does NOT over-diagnose. If anything, I think they totally underdiagnose. They found nothing for my kid (although the evaluators all told me off book that he plainly had issues) because he could pass all the little tests, even though he was bending over backwards (literally!) to do them.

I think the preschool teachers are probably the best situated person to observe a problem (because often problems only show up in a group, and not when you are one on one with you child) ...but if what the teacher is saying does not resonate in any way with your own experience or what other adults (relatives, coaches, previous teachers) have observed, then I would be very concerned that it is some dynamic in the classroom that is causing the problem.

Childfind doesn't actually "diagnose." You are qualifying for services b/c the delays your child is having meet a certain threshold and has an "educational impact."

Early Intervention also doesn't diagnose. You are qualifying for services by meeting a certain percentage of delays.

Either way, your kid can have delays not acknowledged by Childfind or EI.

Maybe not subtle things, but their findings typically point to larger issues, if there are any.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Childfind definitely does NOT over-diagnose. If anything, I think they totally underdiagnose. They found nothing for my kid (although the evaluators all told me off book that he plainly had issues) because he could pass all the little tests, even though he was bending over backwards (literally!) to do them.

I think the preschool teachers are probably the best situated person to observe a problem (because often problems only show up in a group, and not when you are one on one with you child) ...but if what the teacher is saying does not resonate in any way with your own experience or what other adults (relatives, coaches, previous teachers) have observed, then I would be very concerned that it is some dynamic in the classroom that is causing the problem.

Childfind doesn't actually "diagnose." You are qualifying for services b/c the delays your child is having meet a certain threshold and has an "educational impact."

Early Intervention also doesn't diagnose. You are qualifying for services by meeting a certain percentage of delays.

Either way, your kid can have delays not acknowledged by Childfind or EI.

Maybe not subtle things, but their findings typically point to larger issues, if there are any.

Nope, they don't. Their findings may point that your kid has a speech delay. With ST, that may resolve. (They may resolve on their own without ST but why take that chance.) Or they persist even with ST and be connected to language based LDs down the road.

I've also known many kids (including my own) who have had significant delays and been rejected by EI and Childfind for services and received them after appealing and documenting delays from outside sources.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Childfind definitely does NOT over-diagnose. If anything, I think they totally underdiagnose. They found nothing for my kid (although the evaluators all told me off book that he plainly had issues) because he could pass all the little tests, even though he was bending over backwards (literally!) to do them.

I think the preschool teachers are probably the best situated person to observe a problem (because often problems only show up in a group, and not when you are one on one with you child) ...but if what the teacher is saying does not resonate in any way with your own experience or what other adults (relatives, coaches, previous teachers) have observed, then I would be very concerned that it is some dynamic in the classroom that is causing the problem.

Childfind doesn't actually "diagnose." You are qualifying for services b/c the delays your child is having meet a certain threshold and has an "educational impact."

Early Intervention also doesn't diagnose. You are qualifying for services by meeting a certain percentage of delays.

Either way, your kid can have delays not acknowledged by Childfind or EI.

Maybe not subtle things, but their findings typically point to larger issues, if there are any.

Nope, they don't. Their findings may point that your kid has a speech delay. With ST, that may resolve. (They may resolve on their own without ST but why take that chance.) Or they persist even with ST and be connected to language based LDs down the road.

I've also known many kids (including my own) who have had significant delays and been rejected by EI and Childfind for services and received them after appealing and documenting delays from outside sources.

My child's 0-3 evaluation was at a Children's Hospital and took hours. When I look at the results from the evaluation, done when he was about 23 months old, they are surprisingly accurate, even though my child is now a teen. They got a very good snapshot of what was going on. It wasn't a diagnosis per se, but they didn't miss anything.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Childfind definitely does NOT over-diagnose. If anything, I think they totally underdiagnose. They found nothing for my kid (although the evaluators all told me off book that he plainly had issues) because he could pass all the little tests, even though he was bending over backwards (literally!) to do them.

I think the preschool teachers are probably the best situated person to observe a problem (because often problems only show up in a group, and not when you are one on one with you child) ...but if what the teacher is saying does not resonate in any way with your own experience or what other adults (relatives, coaches, previous teachers) have observed, then I would be very concerned that it is some dynamic in the classroom that is causing the problem.

Childfind doesn't actually "diagnose." You are qualifying for services b/c the delays your child is having meet a certain threshold and has an "educational impact."

Early Intervention also doesn't diagnose. You are qualifying for services by meeting a certain percentage of delays.

Either way, your kid can have delays not acknowledged by Childfind or EI.

Maybe not subtle things, but their findings typically point to larger issues, if there are any.

Nope, they don't. Their findings may point that your kid has a speech delay. With ST, that may resolve. (They may resolve on their own without ST but why take that chance.) Or they persist even with ST and be connected to language based LDs down the road.

I've also known many kids (including my own) who have had significant delays and been rejected by EI and Childfind for services and received them after appealing and documenting delays from outside sources.

My child's 0-3 evaluation was at a Children's Hospital and took hours. When I look at the results from the evaluation, done when he was about 23 months old, they are surprisingly accurate, even though my child is now a teen. They got a very good snapshot of what was going on. It wasn't a diagnosis per se, but they didn't miss anything.

A evaluation through Children's isn't comparable to an evaluation through Childfind or EI. One would hope it would be a lot more comprehensive. I agree though, sometimes you don't get a diagnosis, but being thorough is extremely helpful, especially at a young age.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Childfind definitely does NOT over-diagnose. If anything, I think they totally underdiagnose. They found nothing for my kid (although the evaluators all told me off book that he plainly had issues) because he could pass all the little tests, even though he was bending over backwards (literally!) to do them.

I think the preschool teachers are probably the best situated person to observe a problem (because often problems only show up in a group, and not when you are one on one with you child) ...but if what the teacher is saying does not resonate in any way with your own experience or what other adults (relatives, coaches, previous teachers) have observed, then I would be very concerned that it is some dynamic in the classroom that is causing the problem.

Childfind doesn't actually "diagnose." You are qualifying for services b/c the delays your child is having meet a certain threshold and has an "educational impact."

Early Intervention also doesn't diagnose. You are qualifying for services by meeting a certain percentage of delays.

Either way, your kid can have delays not acknowledged by Childfind or EI.

Maybe not subtle things, but their findings typically point to larger issues, if there are any.

Nope, they don't. Their findings may point that your kid has a speech delay. With ST, that may resolve. (They may resolve on their own without ST but why take that chance.) Or they persist even with ST and be connected to language based LDs down the road.

I've also known many kids (including my own) who have had significant delays and been rejected by EI and Childfind for services and received them after appealing and documenting delays from outside sources.

My child's 0-3 evaluation was at a Children's Hospital and took hours. When I look at the results from the evaluation, done when he was about 23 months old, they are surprisingly accurate, even though my child is now a teen. They got a very good snapshot of what was going on. It wasn't a diagnosis per se, but they didn't miss anything.

A evaluation through Children's isn't comparable to an evaluation through Childfind or EI. One would hope it would be a lot more comprehensive. I agree though, sometimes you don't get a diagnosis, but being thorough is extremely helpful, especially at a young age.

This wasn't Children's up here. It was a children's hospital and diagnostic center in Florida that was designated to do the ChildFind evaluating (I think it was called Early Steps in Florida). It was thorough and spot-on. There were some things they saw there that didn't manifest until years later. I had put the report aside but looked at it recently, and was surprised and even the more subtle things they noticed back then.

[Anonymous]

Just like with many medical professionals, the range in quality of psychologists is quite large--probably larger than in many other fields. Even with the PhD programs they go to, some are fantastic, many are good, plenty are adequate but not great, and some are crap. Let alone their specific mentorship, training, skills, etc... The better ones will be at more prominent institutes. A school that pays poorly is not a prominent institute so unless it's someone doing it for the love of it in that environment, you aren't getting the best and the brightest in the field. There will always be exceptions, but it definitely adds to the challenge of getting a good evaluation that is free.

[Anonymous]

My DS was definitely 'over' diagnosed at an evaluation - but it was hedged, since many of the diagnoses are a range of what it might be - or could develop or not - when kids are young. My bigger takeaway was that the evaluation is part of a process and not an end point - more a beginning - where he started therapy, responded to it well & has benefited from it, no matter what the 'labels' may or may not have been. The OTs he saw still shrug that it may be one thing or another - but I tried after a while to focus on the 'how to help my child' more than the imprecise nature of diagnoses in this field

[Anonymous]

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).

As some PPs have suggested, if the teacher is insistent there is a problem then the schools should be doing the testing. I would start there because they'll do some standardized testing as well as classroom observations. Based on those results, you can either do nothing, accept any services the school may offer or take the school reports to a private professional for your own evaluation. The school testing is at no cost to you and there is little risk involved. It's just a start and a snapshot in time.