Try a nutritionist.

Anonymous wrote:OP here. I wanted to provide an update. That way, if anybody searches for similar things, they can read this.

I sincerely thank you all for your kind words.

(I’m not in VA, so don’t ask for doctor recommendations! Sorry!)

I was so lucky to get him in to the developmental pediatrician last week on a cancellation. We went and I feel like we FINALLY have a plan.
She wants to give it 4-6 months of OT and diet change before a low dose of Zoloft, but she did say that the low-dose of Zoloft can be a game changer.
She said he might be on the autism spectrum, and that will come out as the social demands increase.

We are lucky to have found an opening with OT and hopefully start very soon. We are currently looking around for a food therapist also since he has limited his foods to about 10 things he will eat. I really think that his poor diet explains a lot of his behavior.

She said that I neuropsych evaluation is not necessary at this time, because it usually provides answers to a lot of unknowns… And he’s not completely unknown. He definitely has anxiety and ADHD and autism like tendencies. She did say everything will likely get worse as he ages, which is too bad, but I’m glad that we are on the right track.

OP - if it makes you feel better, v similar kid, who a neurospych also said would 'get worse' and it didn't get worse it got better.
I will say that included adderall, OT, therapy, and most of all a lot of sports (like 7d per week mostly- we are in a moment of no weekend sports and it's dicey but like an amazing vaca for me in a way for a few weeks) and a lot of parent training. and a TON of socialization and discussion. But it did get better and not just like 'kid is masking and faking it' better, like kid genuinely not only learned to appreciate others perspectives but now really enjoys and likes to think about others, and works hard at own emotional regulation. It is NOT perfect at ALL. But it did not get worse.

NP here and appreciate all the previous replies. Wanted to ask more about efforts to improve iron levels and non-conventional ways to do that. For context: DD is 14.5, anxiety/AdHD/ASD. Very selective eater that has gotten worse over the last few years. Also on the very delayed end of puberty so just really starting the process now (no period yet, but has finally started growth spurt). Ped finally did a full blood panel last year and iron (ferritin) was low so recommended 2x a day supplement. DD took supplements for a few weeks and then refused based on non-specific stomach/bathroom issues. (DD has always refused to discuss any of this, even as a small child, so no hope in specifics). Given delayed puberty, DD was seen and cleared by endocrin this summer (with some additional bloodwork). Diet is very low in iron - almost no meat, no cereal, no veges, eggs occasionally, and just low volumes of food generally. We’ve started working with an OT for food/sensory/interception issues, in addition to long-time psychologist support and psychiatrist (SSRI since age 6). Plus tutoring for schoolwork. Obviously we’re dealing with a lot of support needs, so this concern is there but also one.more.thing among many.

Other things to research or look into given the iron issue? Ive only read a little about the connections between mood/anxiety/etc and levels, and not even sure what other kinds of doctors handle the more nuanced cases like this. We’re in NoVa, and I appreciate anything helpful that can be shared. Thanks.

OP here. I wanted to provide an update. That way, if anybody searches for similar things, they can read this.

I sincerely thank you all for your kind words.

(I’m not in VA, so don’t ask for doctor recommendations! Sorry!)

I was so lucky to get him in to the developmental pediatrician last week on a cancellation. We went and I feel like we FINALLY have a plan.
She wants to give it 4-6 months of OT and diet change before a low dose of Zoloft, but she did say that the low-dose of Zoloft can be a game changer.
She said he might be on the autism spectrum, and that will come out as the social demands increase.

We are lucky to have found an opening with OT and hopefully start very soon. We are currently looking around for a food therapist also since he has limited his foods to about 10 things he will eat. I really think that his poor diet explains a lot of his behavior.

She said that I neuropsych evaluation is not necessary at this time, because it usually provides answers to a lot of unknowns… And he’s not completely unknown. He definitely has anxiety and ADHD and autism like tendencies. She did say everything will likely get worse as he ages, which is too bad, but I’m glad that we are on the right track.

Anonymous wrote:

Anonymous wrote:I would see a specialist for the low tone and restless legs and anemia. And get a sleep study-- he may be sleeping really poorly.

We did a sleep study which confirmed restless legs.

One of the causes of restless legs is low iron. How is his diet. When you supplement iron, do the levels improve? If not, you should look at issues with absorption such as celiac disease.

Anonymous wrote:Please don't rely just on the developmental pediatrician. At age 8.5, he needs a complete neuropsych assessment and perhaps a complete assessment from a speech and language pathologist including pragmatic speech.

Who did the testing at age 4? Contact that person and get the records of the assessment.

THIS

Anonymous wrote:

Anonymous wrote:I have never heard a neuropsych not diagnose something. If you get a neuropsych you get a dx - likely more than one

Huh? I certainly have.

+1 We were told, the kid has some characteristics of certain diagnoses and could benefit from some targeted therapies, but does not have the right combinations to get an actual diagnosis. This basically meant if we wanted to help him, we had to pay for it all out of pocket privately; no insurance and no school intervention, even though the specific characteristic and symptoms were causing major problems sociaily and academically.

Same on the physical side of things: with our infant who couldn't hold his head up or use his hands effectively to grasp, pinch, or hold, was but was 'just a smidge on the 'normal' side of tone," so while the doctor said PT was absolutely necessary for physical development and eventually achieving milestones, it would not be covered by insurance and did not qualify for any school based services later in life.

I read these 'over diagnosis' threads with a huge eye roll. And those suggesting teachers would point it out if there was a problem, no, not unless your kid is throwing tables. They don't have time for the paperwork.

Very similar situation in my house too and I agree with the recs. Aso get your kid an OT evaluation for the low tone and table manners. Latter could be related to poor fine motor skills or lack of sensory awareness that could be affecting other things like handwriting and add sufficiency.

As for school, there’s a very big difference between second and third grade. Maybe part of why you’re getting so frustrated now is that your kid is getting frustrated by the demands of school, and it could be related to his learning profile or his physical limitations. In any case, definitely get some testing, including neuropsych. It will feel like an endless wait, and then more wait while you determine how to approach it, at least that’s how it is here, but it is the first step on a journey that I believe will
Lead to someplace better.