PSA on neuropsychs

[Anonymous]

Just posting to say we got a neuropsych done at DC's private school teacher's request (no referral needed), and the psychologist who conducted it identified a number of issues and suggested therapeutic treatment ideas. We opted for a drug-free regimen with multiple different kinds of therapy. It took a year for DC to get comfortable with the therapy, and then this year DC finally made soooooo much progress. With the help of intensive therapy, DC has gone from 3+ years behind grade level in some subjects to at or above grade level across the board. It takes an excellent psychologist doing the neuropsych, parents who are highly involved, and enough resources (with the help of the neuropsych results, we've been able to get insurance coverage for just about everything) to carry out all of the recommendations. I get that not everyone can have such a great experience, but I personally cannot recommend it enough. Without that initial neuropsych, I am positive DC's issues would have gotten worse rather than more manageable!

[Anonymous]

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Anonymous wrote:Neuropsych evals can be very helpful in the situations you described, but there is also a tendency on this board for people to recommend neuropsych evaluation as a first step when there are other options that may be faster, cheaper, and effective. For example, if a parent suspects their child may have mild to moderate anxiety or ADHD, an intake appointment with a child psychologist or psychiatrist may be fully effective in diagnosing, treating, and getting school accommodations.

+1 billion

Which thread suggests getting a neuropsych as the first step? The ones I see pertain to kids who are currently getting services/therapy or were until very recently. I think y'all have created a straw man here just to entertain yourselves.

PLENTY of threads have an OP that says "i think my kid has ADHD" and someone is like "get a neuropsych!!" which is cart before the horse territory.

I don’t think it is cart before horse necessarily. ADHD is one of the few diagnoses that can be diagnosed by a variety of health professionals - pediatrician, psychiatrist, NP, PA, etc. however, it is also a diagnosis that can be mistaken for other issues or can be comorbid - along with depression, anxiety, and a variety of specific learning disorders like dyslexia, dyscalculia, MERLD and other language processing disorders. For kids who have comorbid disorders, particularly SLD or language processing, it’s really only the neuropsych that’s going to be able to be able to diagnose comorbidities with data to support the diagnosis. Neither a pediatrician nor a psychiatrist will really be able to diagnose dyslexia along with the ADHD.

Also some accommodation processes still demand neuropsych level testing (wrongly & illegally IMO - but hard to fight it.) also, some schools will really refuse to recognize the comorbid LD diagnoses w/o neuropsych level data. Again, wrong & illegal, but hard to fight.

As a parent who has had to choose diagnostic pathways less expensive than neuropsych, I get why people don’t like the really privileged neuropsych first advice. But, I’m also very aware that more data would have been better in our situation to fully flesh out the parameters of the ADHD and other disorders. Also, as a parent who has a kid who was suspected to have ADHD but who really has an underlying physical disorder causing attention and cognitive problems, I can see clearly that the neuropsych can only describe the cognitive deficits. It can’t diagnose or even point to the specific medical issue causing ADHD-like symptoms.

You don’t need a neuropsych to diagnose dyslexia.

The PP didn't say you need a neuropsych to diagnose dyslexia in every case, they described how you need it when there are comorbid conditions that make the picture more complicated.