Everything is so expensive!

[Anonymous]

It's 7.5% of AGI. Count everything not just the kid stuff.
https://www.irs.gov/taxtopics/tc502

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What are the evidenced based therapies for anxiety? People always say do your research. But I’m not a scientist. I don’t understand what research papers say.

I just posted but according to our psychiatrist meds + therapy. (True for adults too)

OP here - so would this be anxiety medication in addition to ADHD medication? Seems like a lot at once. And the dr who performed the neuropathy is hopeful treating the ADHD will largely address the anxiety.

Most doctors want kids to try therapy before moving to meds for anxiety.

[Anonymous]

Anonymous wrote:I always get blasted on here when I point out that everyone is out for SN parents’ money and that you need to be very discerning about what you throw money at.

Just because someone did testing and said your child has all of these conditions does not mean they all need therapy or the type of therapy suggested or all the therapy at the same time.

Nothing can substitute for you yourself knowing your child and identifying the key challenges that need support right now.

If she is in K and struggling with reading and writing, then you need OT and a strong IEP with pullouts.

If she is in MS and not completing homework, then more structure and routine.

If she has anxiety affecting her daily, then evidence-based therapy like SPACE.

and so on.

I agree with this. There are always people that will take your money and guilt you into spending more.
There are some really great CBT based books for kids that can really help with anxiety and also with some of the ADHD symptoms. Make sure you've read some basic books on parenting a kid with ADHD, because you can get at least 50% of the way there with structure and solutions that you implement at home.
We found the weekly therapy to be basically useless. Insurance did cover a small amount of it, but it was a very small percentage for the mental health therapy, and a somewhat higher percentage for the OT. I definitely wouldn't be doing more than 2x a week of anything --- kids need time to be a kid, and having them in therapies every day of the week will just lead to exhaustion for you and then. Thisi s a marathon situation, not a sprint. If the anxiety is extreme, I would focus on that but make sure you are using someone that uses CBT, not just talk therapy, and has an anticipated end date for the treatment.

We are paying for an Exec Function coach for HS, and maybe should have started that in MS.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What are the evidenced based therapies for anxiety? People always say do your research. But I’m not a scientist. I don’t understand what research papers say.

I just posted but according to our psychiatrist meds + therapy. (True for adults too)

OP here - so would this be anxiety medication in addition to ADHD medication? Seems like a lot at once. And the dr who performed the neuropathy is hopeful treating the ADHD will largely address the anxiety.

We have a very good psychiatrist who prescribes, and this is his approach:

First medicate whichever issue is causing the most difficulty. For many kids with anxiety, that will be the anxiety UNLESS you think it's the ADHD that is causing the anxiety. Start with one medication that tends to work best for the most kids, start low, and gradually increase until the symptoms are tolerable with only tolerable side effects. Then you can start slowly adding in another medication to deal with the other problem.
For my kid with anxiety and ADHD, we ended up dropping the ADHD medication for a while as it was hard to find one that didn't make the anxiety worse, or cause tics. But fast forward a couple of years and the anxiety had largely resolved, in part with CBT/DBT skills training. She now takes an extremely low dose medicine for the ADHD, and deals with the anxiety through the skills she learned in DBT.
THere are ADHD medications that are less likely to cause anxiety -- but the nonstimulant ADHD medications don't tend to work for as many kids. And finding a stimulant that doesn't make the anxiety worse is largely hit or miss.
I'm not sure if you said how old your kid is, but my approach is as follows: 1) Help your kid with scaffolding to take off the stress and lessen the anxiety. 2) Don't sweat the small stuff. If they aren't in HS yet, grades truly don't matter. It's okay not to do all your homework or make your bed or whatever. Let that stuff go, so long as it won't create long-term effects. 3) Learn the skills that will happen lessen the anxiety. There are a LOT of tricks/skills you can use to work around ADHD. The more a kid learns those and figures out which ones work for them, the more at ease that kid will be in their own skin.
I do question whether having a ton of therapies might be counter-productive, as it might make the kid feel that the ADHD is running their life. Acknowledging it and learning to deal with it is helpful, but making their whole life about the ADHD and anxiety is probably not helpful. The thing that helped my kid's anxiety the MOST was getting into a club at school that she was super invested in .... the more time she spent on that activity, the less time she had to run the gears in her head on over-drive about what she could've/would've/should've done.
Just my two sense as a mom with ADHD with two kids with ADHD.

[Anonymous]

Cents -- not sense -- sorry typing too fast! There's probably a pun in there somewhere.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What are the evidenced based therapies for anxiety? People always say do your research. But I’m not a scientist. I don’t understand what research papers say.

I just posted but according to our psychiatrist meds + therapy. (True for adults too)

OP here - so would this be anxiety medication in addition to ADHD medication? Seems like a lot at once. And the dr who performed the neuropathy is hopeful treating the ADHD will largely address the anxiety.

as a person with generalized anxiety, I find this very strange. ADHD meds are known to increase anxiety not reduce it. If the child has clinical anxiety that needs to be treated then the meds are SSRIs and you need a referral to SPACE or the Ross Center or another anxiety specialist.

[Anonymous]

Anonymous wrote:As a parent of a high functioning autistic/adhd child who is now 10 but was diagnosed of having autism around age 2. Here’s what I have learned:
1. It’s a marathon and not a sprint
2. Don’t give up the dreams that you have for your child, that means prioritizing his/her and your family’s overall well being.
3. List them for Medicaid waiver. You may be on the list forever but in case something happens it may be an option.
4. If possible, both parents should continue to work full time and save for retirement
5. Sign up for able account for your child
6. For therapies, there is a lot out there but some of it is just not evidence based. So, knowing what your child needs is the best way to tease out what the specific needs are. If you got a neuropsych, ask the provider what the priorities are to focus on 1 year from now, 3 years from now and 5 years. This will help you get clarity.
7. If you are not in healthcare, use reputable online resources to gather information, this will help to again tease out what may help or not.
8. Have faith and good luck

This is such good advice. Can someone with ASD1 get that waver? How helpful is it?

[Anonymous]

I think sometimes this forum groups everyone in as adhd or autism parents. For my kid with cerebral palsy- OT has been essential. We needed to learn everything- how to position our child, range of motion exercises for my kid, feeding challenges, etc. I have met many OTs (and PTs) who prefer treating kids with more motor based or “medical” diagnoses. Also has been essential for getting us all sorts of equipment we need in our home. I think the progress is more evident and their training prepares them more than the more social or behavioral challenges of Autism and adhd. Not to say there aren’t motor challenges w those diagnoses but it is very different. This is just my two cents

[Anonymous]

OP - $700 a week for therapies for a kid with run of the mill ADHD and LDs? You're being conned.

Get OTs in school for free. One hour a week of tutoring. Simplify your life, not complicate it. Agree with the other posters that the vast majority of the people suggesting these services are not "holistic" experts, in that they have zero idea how to help your kid big picture. They just see some evidence of the thing that they provide therapy for, and amazingly are willing to offer you those services.

I'm a parent of a kid with SEVERE ADHD. As in, kicked out of multiple preschools and on medication at age 4. Still a very quirky kid at age 13. We've done a lot: OT, therapy, speech, school OT, social skills, sensory training, counseling. Only thing that made any obvious difference was medication. The rest: It all improves with time (if it was going to improve). The "evidence based" science on any of this stuff is weak at best.

Save your money, help your kid do okay in school, and forget the rest.

I also think anyone who managed to get to a place in childhood where you were doing ZERO therapies until suddenly you got a ADHD and LDs diagnosis -- that probably means the ADHD is pretty light. Don't get sucked into the vortex, OP.

[Anonymous]

Anonymous wrote:I think sometimes this forum groups everyone in as adhd or autism parents. For my kid with cerebral palsy- OT has been essential. We needed to learn everything- how to position our child, range of motion exercises for my kid, feeding challenges, etc. I have met many OTs (and PTs) who prefer treating kids with more motor based or “medical” diagnoses. Also has been essential for getting us all sorts of equipment we need in our home. I think the progress is more evident and their training prepares them more than the more social or behavioral challenges of Autism and adhd. Not to say there aren’t motor challenges w those diagnoses but it is very different. This is just my two cents

you’re totally right to point that out especially about OT. the problem is that OT is pushed on autism/adhd parents as a treatment for all sorts of stuff it does not actually do. On the flip side, a lot of kids with autism also have dyspraxia/motor planning issues, so some of the skills overlap with the skills needed for your child, albeit different.

[Anonymous]

Anonymous wrote:OP - $700 a week for therapies for a kid with run of the mill ADHD and LDs? You're being conned.

Get OTs in school for free. One hour a week of tutoring. Simplify your life, not complicate it. Agree with the other posters that the vast majority of the people suggesting these services are not "holistic" experts, in that they have zero idea how to help your kid big picture. They just see some evidence of the thing that they provide therapy for, and amazingly are willing to offer you those services.

I'm a parent of a kid with SEVERE ADHD. As in, kicked out of multiple preschools and on medication at age 4. Still a very quirky kid at age 13. We've done a lot: OT, therapy, speech, school OT, social skills, sensory training, counseling. Only thing that made any obvious difference was medication. The rest: It all improves with time (if it was going to improve). The "evidence based" science on any of this stuff is weak at best.

Save your money, help your kid do okay in school, and forget the rest.

I also think anyone who managed to get to a place in childhood where you were doing ZERO therapies until suddenly you got a ADHD and LDs diagnosis -- that probably means the ADHD is pretty light. Don't get sucked into the vortex, OP.

+1 except that if the child actually has meaningful anxiety, there are real therapies for that, but they are focused and the therapist wants you to be done in 3-6 months, not continue forever.

but good point about going from zero to $700 suddenly. If the diagnoses are serious enough to warrant that, it’s unlikely you would have been doing nothing before. We were doing therapy for years prior to any diagnosis because the challenges were totally obvious (motor skills & behavior).

[Anonymous]

Anonymous wrote:My DD recently diagnosed with ADHD, anxiety, and several learning disorders. We need for her: weekly OT, weekly therapy for anxiety, and two times a week tutoring. These therapies/tutors cost $700 a week. That doesn’t count the Dr to prescribe ADHD medication, which I’m hoping will be covered by insurance.

What can we do to offset these costs? Does anyone have experience getting the therapy and OT covered by insurance and what do I need for that? Can I get the tutoring covered by insurance or talent out of a 529?

Any thoughts on how to cope with these costs would be appreciated. Thanks in advance!

My 18 year old DC also has anxiety, a learning disorder, and a couple of medical conditions as well. It is terribly expensive. I agree with the previous posters who point out that you should make sure that any therapies you sign on for are evidence based. I also have worked hard to make sure that as much as possible my DC's life is not consumed by medical/therapy appointments. In high school, I've tried to limit therapy/doctor's appointments to 1-2x a week, which has meant using a type of triage system where we address the most pressing issue first (except for when there has been a sudden urgent development).

I would temper a bit of the above advice with a reminder that although treatments/therapies, etc are expensive, some at least have the potential to change the tragetory of your child's life. Our DC's life is so much better now than it was when DC was first diagnosed. DC went from a child who was really struggling socially (no friends, panic attacks, ) and academically (failing tests) to a child who has a lot of friends, has leadership roles in school, and gets good grades. We drive old junkers, and don't go on vacations, and don't eat out, but it was totally worth it because our child's now has a chance at a future that DC wouldn't have had without intervention.

No one has an unlimited budget, we can only do what our bank accounts allow, but the rewards for these interventions can be great.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What are the evidenced based therapies for anxiety? People always say do your research. But I’m not a scientist. I don’t understand what research papers say.

I just posted but according to our psychiatrist meds + therapy. (True for adults too)

OP here - so would this be anxiety medication in addition to ADHD medication? Seems like a lot at once. And the dr who performed the neuropathy is hopeful treating the ADHD will largely address the anxiety.

We have a very good psychiatrist who prescribes, and this is his approach:

First medicate whichever issue is causing the most difficulty. For many kids with anxiety, that will be the anxiety UNLESS you think it's the ADHD that is causing the anxiety. Start with one medication that tends to work best for the most kids, start low, and gradually increase until the symptoms are tolerable with only tolerable side effects. Then you can start slowly adding in another medication to deal with the other problem.
For my kid with anxiety and ADHD, we ended up dropping the ADHD medication for a while as it was hard to find one that didn't make the anxiety worse, or cause tics. But fast forward a couple of years and the anxiety had largely resolved, in part with CBT/DBT skills training. She now takes an extremely low dose medicine for the ADHD, and deals with the anxiety through the skills she learned in DBT.
THere are ADHD medications that are less likely to cause anxiety -- but the nonstimulant ADHD medications don't tend to work for as many kids. And finding a stimulant that doesn't make the anxiety worse is largely hit or miss.
I'm not sure if you said how old your kid is, but my approach is as follows: 1) Help your kid with scaffolding to take off the stress and lessen the anxiety. 2) Don't sweat the small stuff. If they aren't in HS yet, grades truly don't matter. It's okay not to do all your homework or make your bed or whatever. Let that stuff go, so long as it won't create long-term effects. 3) Learn the skills that will happen lessen the anxiety. There are a LOT of tricks/skills you can use to work around ADHD. The more a kid learns those and figures out which ones work for them, the more at ease that kid will be in their own skin.
I do question whether having a ton of therapies might be counter-productive, as it might make the kid feel that the ADHD is running their life. Acknowledging it and learning to deal with it is helpful, but making their whole life about the ADHD and anxiety is probably not helpful. The thing that helped my kid's anxiety the MOST was getting into a club at school that she was super invested in .... the more time she spent on that activity, the less time she had to run the gears in her head on over-drive about what she could've/would've/should've done.
Just my two sense as a mom with ADHD with two kids with ADHD.

OP here - what are these skills/tricks? Where can I read more about them?

[Anonymous]

OP here - People have a lot of doubts about what we’re doing so I’m back to provide some more information.

We’re at a private school so no IEP or free services. We do have the learning specialists and smaller class sizes that come with private and they’ve been helpful.

We’ve been doing therapy for two years and it’s been extremely helpful for her and for us. She’s gone from intolerable, disruptive, aggressive, impulsive behavior to good behavior. She’s still getting value from therapy and not ready to stop yet.

She needs OT for fine motor. She’s almost 9 and can’t use a zipper or buttons. Her handwriting is very bad and her work is messy.

She needs tutoring twice a week because she’s a year behind in one of her subjects.

Of everything - probably therapy is what we could most likely drop and it’s the most expensive ($250 a week). But she’s still getting value and it’s helped so much that I don’t want to quit yet until she’s ready. But it would make a huge difference to figure out how to get the therapy and the OT covered by insurance. We have a high deductible plan so OON doesn’t matter once we hit our deductible. I’m not sure how to get it reimbursed though - what kind of documentation we need or if we need a Rx for the therapies.

Thanks for the help and please don’t hate me that we have the resources for private school and therapy. We save elsewhere and are lucky to have two good salaries. Honestly I stay in my very demanding and stressful job because it has afforded us the ability to pay for what she needs.

[Anonymous]

I wanted to thank everyone who chimed in on this thread. I am not OP and while my 6 yo was flagged as at risk for developing ADHD he has not been diagnosed (and had a full neuropsych eval). He has an IEP and gets great services through public school. We have been paying $15K/yr out of pocket for private OT on top of the OT he gets at school, and my husband and I just now had the courage to realize it was not worth it anymore. It's easy to forget that someone who tells you they want to help your kid is running a business like any other.