Quince Orchard Psychotherapy in the Kentlands, Germantown, and Frederick does the testing and Blue Cross covers it almost completely.

Anonymous wrote:

Anonymous wrote:

PP again. Just realized you don't have a formal diagnosis.

Pediatricians are not mental health experts, OP. Never do this through the ped! Your child needs to be thoroughly evaluated by a reputable psychologist with experience in ADHD. The neuropsychological eval is expensive, but worth every penny since it is so informative and detailed. We used it to get an IEP from the school, so my son could have the relevant accommodations and support in school. The report was so good that the school did not fight it, as they are wont to do otherwise.

ADHD meds should never be given to a child without the guidance of an experienced psychiatrist. Ours is Dr. Hemanth in North Bethesda. I highly recommend her.

How much did you pay for your neuropsych evaluation? Did insurance cover any part of it?

$3200, none of which was covered. Still some of the best money I ever spent, and we'd be considered poor by DCUM standards.
The price will vary a bit with the practice you choose and which tests they feel your child is going to need, but it will be ballpark that amount. Came with a bulletproof report, right down the addition of MCPS-speak in bold, so that the school would not miss the relevant diagnoses.

Anonymous wrote:

Anonymous wrote:
My 12 year old son was diagnosed with moderate to severe mixed-type ADHD and specific math and fine motor learning disorders at 10 and has an extremely low processing speed without meds.

He takes 27mg of generic Concerta (extended release) and it works like a charm. You should consult with a psychiatrist to tweak the dose. Perhaps your child needs a little more.

Stixrud evaluated him with the full neuropsych, 8 hours of testing over two days, comprising of a WISC V (IQ) test and specific testing to identify ADHD and other issues. Some of his IQ subscores were in the gifted range, but others were well below normal, like processing speed and working memory.

His math recall was significantly affected (not so much spelling, as he is a voracious reader). He eats and does things excruciatingly slowly when not on meds, and has significant oral, sensory and fine motor issues.

I was told by the psychologist at Stixrud that all these issues are linked.

Have you done anything to help with working memory?
DId processing speed improve with Concerta or is he working on strategies to improve?

I didn't do anything specifically to help with memory or speed, since these brain functions were so altered that I felt they could not be improved without medication. It would be like asking a myopic person to train herself to see without glasses.

BUT - since I'm a Tiger parent at heart, we have always done academic work with DS since he was little, as well as writing exercises and OT for his fine motor skills. None of this was visible at school, because he was so incredibly inattentive and slow.

Then when he started meds, all that prior work paid off and he was instantly more responsible and could use the study skills he had been honing for years. It's just that he needed the meds for all of this to reveal itself. We had been told that usually kids need a few years to develop study skills after starting ADHD meds, since they come with a developmental lag for those skills, but for him that was not the case, since I had trained him for ages without realizing it. That was when he switched from regular math class, where he had been struggling, to an advanced math class, and got straight As throughout his 6th grade year.

An interesting thing about the processing speed: out of curiosity, I had him tested for IQ before and after meds. The processing speed was significantly improved, which the psychologist told us was to be expected.

I have two with very low processing speed and very very high verbal scores. Concerta was good for one and not the other. Where it helped, I think it helped with overall coping rather than improving processing speed specifically. It made my other one super anxious and we still don't have a good solution.

In response to the original post, I do think all of the slow pace stuff and spaciness comes back to processing speed. It's all related.

We paid $3400 for a neuropsych and our insurance reimbursed us about $600.

Some are less - some are more. Depends on the provider and what your concerns are. Children's Hospital and the Kennedy Krueger Institute in Baltimore do them - and people have better luck with insurance. But the wait lists can be long.

Anonymous wrote:

PP again. Just realized you don't have a formal diagnosis.

Pediatricians are not mental health experts, OP. Never do this through the ped! Your child needs to be thoroughly evaluated by a reputable psychologist with experience in ADHD. The neuropsychological eval is expensive, but worth every penny since it is so informative and detailed. We used it to get an IEP from the school, so my son could have the relevant accommodations and support in school. The report was so good that the school did not fight it, as they are wont to do otherwise.

ADHD meds should never be given to a child without the guidance of an experienced psychiatrist. Ours is Dr. Hemanth in North Bethesda. I highly recommend her.

How much did you pay for your neuropsych evaluation? Did insurance cover any part of it?

Anonymous wrote:
My 12 year old son was diagnosed with moderate to severe mixed-type ADHD and specific math and fine motor learning disorders at 10 and has an extremely low processing speed without meds.

He takes 27mg of generic Concerta (extended release) and it works like a charm. You should consult with a psychiatrist to tweak the dose. Perhaps your child needs a little more.

Stixrud evaluated him with the full neuropsych, 8 hours of testing over two days, comprising of a WISC V (IQ) test and specific testing to identify ADHD and other issues. Some of his IQ subscores were in the gifted range, but others were well below normal, like processing speed and working memory.

His math recall was significantly affected (not so much spelling, as he is a voracious reader). He eats and does things excruciatingly slowly when not on meds, and has significant oral, sensory and fine motor issues.

I was told by the psychologist at Stixrud that all these issues are linked.

Have you done anything to help with working memory?
DId processing speed improve with Concerta or is he working on strategies to improve?

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why would she be taking Comcerta without an ADHD diagnosis?

If she has ADHD and the medication hasn't changed her inattentiveness the doctor should prescribe a different one. Talk to your psychiatrist.

She does not have a diagnosis of ADHD through a psychologist. She got diagnosed by her pediatrician based on a parent and teacher survey. That's good enough to get meds, but I don't think it qualifies as a formal diagnosis.

]

Legally it's good enough to get meds. It's a terrible idea though. Take her to a specialist.

What is the recommended path?

Neuropsych to dx
psychiatrist for possible meds
psychlogist for CBT

????

Who/How do you re-evaluate or talk to on a regular basis to make sure things are on the right track?

PP again. Just realized you don't have a formal diagnosis.

Pediatricians are not mental health experts, OP. Never do this through the ped! Your child needs to be thoroughly evaluated by a reputable psychologist with experience in ADHD. The neuropsychological eval is expensive, but worth every penny since it is so informative and detailed. We used it to get an IEP from the school, so my son could have the relevant accommodations and support in school. The report was so good that the school did not fight it, as they are wont to do otherwise.

ADHD meds should never be given to a child without the guidance of an experienced psychiatrist. Ours is Dr. Hemanth in North Bethesda. I highly recommend her.

My 12 year old son was diagnosed with moderate to severe mixed-type ADHD and specific math and fine motor learning disorders at 10 and has an extremely low processing speed without meds.

He takes 27mg of generic Concerta (extended release) and it works like a charm. You should consult with a psychiatrist to tweak the dose. Perhaps your child needs a little more.

Stixrud evaluated him with the full neuropsych, 8 hours of testing over two days, comprising of a WISC V (IQ) test and specific testing to identify ADHD and other issues. Some of his IQ subscores were in the gifted range, but others were well below normal, like processing speed and working memory.

His math recall was significantly affected (not so much spelling, as he is a voracious reader). He eats and does things excruciatingly slowly when not on meds, and has significant oral, sensory and fine motor issues.

I was told by the psychologist at Stixrud that all these issues are linked.

Anonymous wrote:

Anonymous wrote:Why would she be taking Comcerta without an ADHD diagnosis?

If she has ADHD and the medication hasn't changed her inattentiveness the doctor should prescribe a different one. Talk to your psychiatrist.

She does not have a diagnosis of ADHD through a psychologist. She got diagnosed by her pediatrician based on a parent and teacher survey. That's good enough to get meds, but I don't think it qualifies as a formal diagnosis.

]

Legally it's good enough to get meds. It's a terrible idea though. Take her to a specialist.

Anonymous wrote:Why would she be taking Comcerta without an ADHD diagnosis?

If she has ADHD and the medication hasn't changed her inattentiveness the doctor should prescribe a different one. Talk to your psychiatrist.

She does not have a diagnosis of ADHD through a psychologist. She got diagnosed by her pediatrician based on a parent and teacher survey. That's good enough to get meds, but I don't think it qualifies as a formal diagnosis.

Why would she be taking Comcerta without an ADHD diagnosis?

If she has ADHD and the medication hasn't changed her inattentiveness the doctor should prescribe a different one. Talk to your psychiatrist.

When she got tested did they find ADHD? It could be the wrong medication or just being slow to do things could be just a personality trait that has nothing to do with a disability. Does it impact her life or is it just frustrating?

My 11 year old daughter tested very low in the processing speed section of the WISC-IV. I can definitely see where this affects her in issues such as recall of math facts and poor spelling. However she has other issues which don't seem to me as if they would be related to low processing speed. She just does things overall at a slow pace, not even things that have to do with cognitive function, such as eating, getting dressed, and just seems overall kind of flighty. I'm trying to figure out if these are more signs of inattentive adhd than processing speed. The thing is, she has been taking 27mg of Concerta for a year and she still has these issues, which leads me to think it's not adhd. So if not, am I to assume that these issues are due to her processing speed?