You can get on the waitlist at Children's or, if you don't mind the commute, at KKI for dev. ped. Neuropsych can be done starting at 4.5, some practices start at 5 yo, same places (both take insurance) or private practices locally (many are good but won't take any insurance, if you have out of network benefits you can get some reimbursement).

You can also get a developmental assessment at a place like CAAT - geared to early childhood ages to help identify any issues and recommend interventions.

You wait!

I have a son who has recently been tentatively diagnosed with extremely mild cerebral palsy (he is 5 and can swim independently, walked within normal range, and rides a 2 wheel bike, so it is not an immediate obvious case). We also suspect inattentive adhd. He is mostly low tone but has some areas that are high tone. The most helpful Dr for us has far and away been a pediatric physiatrist (pm&r). Developmental ped just ruled out autism and referred us to other specialists. The best activity has been horseback riding for building core strength.

We just had our annual PM&R visit and she referred us to neuropsych, which takes about 6 mos where we are (not in dmv.) she wanted him to have a little kindergarten under his belt.

She said she will make her formal diagnosis after his neuropsych and an mri (which we will wait a few years for so he doesn’t need to be sedated) but she said she would give us a dx now if needed for his IEP (we have had no problems in that department though.)

I don’t like kids on screens. My DD w ADHD is grown now but we did no screens. Minimal tv starting at 3 (PBS a few hours a month) and she had no access to computers (iPads weren’t a thing). She sat at a computer for the 1st time in K. She got her first phone in 8th. But even though I dislike screens for kids, it made no difference in her case. Meanwhile, my youngest who is now in HS seemed like he would be an ADHD diagnosis and it turned out when his speech and motor delays were addressed and he matured, he didn’t have ADHD at all. I think age 3 is really early to draw conclusions. 3 year olds don’t focus and should be expected to be in motion. I do think a developmental pediatrician might still be helpful if you have concerns about other disabilities that are best addressed early.

Anonymous wrote:OP again. When children display more subtle signs of what could be various different diagnoses, what’s the ideal time for a neuropsych? As soon as possible so you can intervene—or later so it’s more accurate. Cost is an issue for us so would rather do it once.

If you did one now, you would almost certainly want to repeat it when the child starts elementary school, due to different needs/stages/etc. at that point. Please do not plan on only getting testing done once and receiving a definitive result at that time.

I would personally be looking at his development and assessing for whether these issues create a functional impairment. Are they impacting kindergarten readiness, for example? I don't know that I would jump to neuropsych testing right now, but I would initiate a conversation with the OT about his progress/skills/development and how they think that will impact kindergarten readiness.

Definitely wait for neuropsych because u want to see if learning is impacted first. You should be able to see learning issues by the end of 1st grade.

OP again. When children display more subtle signs of what could be various different diagnoses, what’s the ideal time for a neuropsych? As soon as possible so you can intervene—or later so it’s more accurate. Cost is an issue for us so would rather do it once.

Anonymous wrote:He’s young but I’m also a big believer in no screens, especially in the early years when their brains are developing.

NP. Agree. Also, 20-40 minutes a day which is probably one or two episodes of Bluey or whatever seems like not much but it's a lot if there were no screens until 2. And the amount will creep up and up over time. Better to cut back to one or two episodes per week rather than per day.

Since ND brains mature more slowly than NT brains, they are "younger" so should be more limited in screen time.. IMO, screens are worse for ND brains than NT brains.

OP here. Thanks, everyone. Reassuring and helpful. Any recommendations for a developmental Ped in DC?

He’s young but I’m also a big believer in no screens, especially in the early years when their brains are developing.

Get on waitlists for a developmental pediatrician. At this age it could a range of things, or nothing.

It could be adhd, it could be autism, it could be a receptive speech related issues, processing issue etc. a developmental pediatrician will track your child and also recommend the appropriate therapies and in school supports. As your child gets a bit older, if medication is warranted they could help there too.

In the meantime you should also request an evaluation through your school district for early intervention or preschool services. They will evaluate your child for any delays and provide support/related services if your child falls outside the range of typical development.

Get them in a play based PK or elementary school for as long as possible and they mature and develop.

I think he seems "spacey" when he's overwhelmed because he's young, and he's struggling with the fine and gross motor aspects of life. For a kid like with motor challenges (especially with low tone), just sitting properly, walking with a group, and engaging in whatever activity is going to take up all of their brainpower, making them seem inattentive or spacey. Really they're just focusing really hard on motor stuff. It's ok.

I don't think taking away screens will make any difference, and you probably need the break. I'm not aware of any rationale that says limiting screen time will make a kid not have inattentive ADD if they do have it.

I think he's too young for anyone to really diagnose or recommend much. A huge percentage of kids that age seem like they might have some kind of ADD. I would continue to focus on the OT since you do know you need that.

DS is a young 3 and in OT for motor planning/fine motor. Teachers also report that he is spacey when asked questions and struggles to focus on non-preferred activities. I can see he is overwhelmed in groups. He is so young that everything may normalize on its own and we’re already doing OT (no speech needs).

But what should I be doing now in case an inattentive ADHD diagnosis is coming?

Is this a case where zero screens make sense? He has 20-40 minutes per day.

Thank you!