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

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Reply to "neuro-psych evaluation --does it always equal a diagnosis?"

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]
To avoid mis-diagnosing your child and wasting your money, you just have to follow two simple rules:

1. DO choose a reputable developmental ped. or psychologist, who is specialized in the issues you are worried about. These have years of experience and will NEVER see a diagnosis where one does not exist, and even then they will usually err on the conservative side (say the disorder is mild instead of moderate or severe). The ones to watch out for are the general peds or bad psychologists - they have no clue what they're doing.

2. Do NOT test too young, or if you do, expect the diagnosis to evolve, or if no diagnosis is given, plan to retest a few years later to see if your child is diagnosable then. Young children are not reliable test-takers before late elementary! The full neuro-psychological evaluation for my 10 year old at Stixrud's lasted 8 or so hours. When children are too young, their reading and understanding of concepts are not developed enough to do in-depth testing and tease out different but similarly-presenting disorders (ex: social issues stemming from inattentive ADHD or mild Asperger's).

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PP who wrote the above. Let me just add that motor, speech and social development in infants and toddlers do not come under the neuro-psych umbrella. For this you go to a developmental ped who will evaluate your child and possibly refer him to occupational, physical, speech or play therapists, etc, as early intervention is absolutely critical. From the bent of OP's question, I understood he or she had an older child who exhibited symptoms of a more behavioral/academic/emotional nature, which would necessitate a neuro-psychological evaluation.

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Hmmmm. Do you want to know why those probably don't come under the "neuro-psych umbrella"? Because there's little evidence that interventions there work. But please prove me wrong: Show me well-published references of randomized controlled trials proving that diagnostic X by a ped leads to treatment Y and to neuro/ behavioral benefits A, B and C.[/quote]

NP.  We had a long discussion with our neuropsych about social skills classes.  There are no long term studies that they really work.  Sure there are several "evidenced based" curriculums but no long term studies ( longer than ~2 yrs) that these things make any real difference in the long term.[/quote]

I'm the first PP quoted.

As a research scientist, I can tell you that research is a slow process because it takes an incredible amount of time and money. So even though there might be "growing evidence" that one type of treatment works for a certain disorder, as in, people are trying it at home and in special classrooms and observing progress not otherwise seen in children without the same treatment, it doesn't mean there is a study in a reputable primary research journal to confirm it. It can take DECADES, literally, before things are confirmed or infirmed scientifically. Research studies contradict each other all the time too, because studies are not assessing exactly the same things in the same populations or using the same methods, leading to additional years of confusion, debate and controversy. Research is often not clear cut. It's a massive worldwide group effort from labs all over the world, where each individual principal investigator decides how to design his own study.

Which means that you as the parent of a child with special needs, need to try different things and intervene early without knowing, some of the time, whether what you're trying will really work. Not only the treatment might not have been proven to work without a shadow of a doubt, but even if it has, it might still not work for your own child, even if he theoretically meets all the criteria. This is due to the idiosyncratic nature of each human being. What works for one may not work for the other.

Bottom line: don't wait for studies. Try something and observe. Discard methods which do not work for your child. Use your own judgement on how long to try each method. Therapies such as speech and social skills groups may never have outrageously visible results, and they are by their very nature difficult to assess, because a child may actually benefit from therapy, but start exhibiting improvement only after months or years. Such is brain development, particularly in very young children. I still don't know whether my son's speech and social skills groups helped him, because I can't compare him to himself had he not received those therapies. In such cases parents have to prioritize. Money, time, logistics and visible results all have to be weighed in the final decision. It becomes a very personal family choice.
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