Anonymous
10/09/2015 12:17
Subject: neuro-psych evaluation --does it always equal a diagnosis?
Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:We are considering allowing dc to be evaluated but are concerned that the evaluater sees everything as a diagnosis waiting to happen.
Has anyone gone through the process and at the end had the evaluater say there is nothing clinical wrong with your kid?
Are there evaluaters who are more focused on seeing the whole child?
You need to get over your irrational fears. Regardless of any diagnosis, if your kid has delays or a learning issue, you get an evaluation to best help your kid.
Just stop it. It is NOT irrational to want to avoid a misdiagnosis. I know you don't believe it, but it happens. There is research showing that every single child evaluated by some autism centers are given an autism diagnosis.
The metlzer center at GW has evals done by students with supervision for much lower costs. Ours was done for free by DCPS. If you request on through the school, its free.
To the OP - pick a reputable clinician and plan to get a second opinion.
I don't know that I have $3500 to $5000 for one evaluation let along $7000 to $10000 for two!
Anonymous
10/09/2015 12:07
Subject: neuro-psych evaluation --does it always equal a diagnosis?
Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:
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).
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.
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.
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.
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.
Anonymous
10/09/2015 11:04
Subject: neuro-psych evaluation --does it always equal a diagnosis?
Anonymous wrote:Anonymous wrote:Does anyone know what the appropriate Childfind group for DC? When I googled it, it looked like the only option is for kids up to the age of 2. DC is 4.
http://www.earlystagesdc.org/
Thanks!
Anonymous
10/09/2015 10:47
Subject: neuro-psych evaluation --does it always equal a diagnosis?
Anonymous wrote:Does anyone know what the appropriate Childfind group for DC? When I googled it, it looked like the only option is for kids up to the age of 2. DC is 4.
http://www.earlystagesdc.org/
Anonymous
10/09/2015 10:42
Subject: neuro-psych evaluation --does it always equal a diagnosis?
Does anyone know what the appropriate Childfind group for DC? When I googled it, it looked like the only option is for kids up to the age of 2. DC is 4.
Anonymous
10/09/2015 10:26
Subject: neuro-psych evaluation --does it always equal a diagnosis?
Childfind definitely does NOT over-diagnose. If anything, I think they totally underdiagnose. They found nothing for my kid (although the evaluators all told me off book that he plainly had issues) because he could pass all the little tests, even though he was bending over backwards (literally!) to do them.
I think the preschool teachers are probably the best situated person to observe a problem (because often problems only show up in a group, and not when you are one on one with you child) ...but if what the teacher is saying does not resonate in any way with your own experience or what other adults (relatives, coaches, previous teachers) have observed, then I would be very concerned that it is some dynamic in the classroom that is causing the problem.
I think the preschool teachers are probably the best situated person to observe a problem (because often problems only show up in a group, and not when you are one on one with you child) ...but if what the teacher is saying does not resonate in any way with your own experience or what other adults (relatives, coaches, previous teachers) have observed, then I would be very concerned that it is some dynamic in the classroom that is causing the problem.
Anonymous
10/09/2015 10:08
Subject: Re:neuro-psych evaluation --does it always equal a diagnosis?
Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:OP,
Stop hiding the ball. How old is your kid and what kind of "therapist" screened him/her. You can't do a quick screen for ASD or ADHD. You can do checklists that might point to concerns but that's not definitive. Talk to your health insurance and find out what is covered. If money is truly an issue, NIH has clinical trials all the time. The screenings are free if your kid qualifies.
You're "skeptical" but you haven't done any of the heavy lifting. You've sought out a therapist of some kind for some reason. Your pediatrician cannot diagnose ASD or ADHD. If those are your concerns, you need to bite the bullet.
+1 You can ask your public school for an evaluation. It will be a psychoeducational evaluation but it will not cost you anything and if it highlights any issues you can schedule your child for a private neuropsych at your cost or ask for an independent educational evaluation which the school system will pay for.
But if the teacher is raising concerns, it'll be well worth it to investigate whether your child needs help instead of dismissing the teacher's concerns because you don't think there is a problem. Obviously, your child is having "problems" at school.
How old is your kid?
I am 22:12 and also 23:51. I am NOT OP and I am not sure why there was a need for such nasty responses (mostly the one two above)? We are not dismissing the teacher's concern. To the contrary, we are pressing ahead even though EVERYONE else is telling is the problem is the teacher (hence the skepticism). I did not mean to hijack OP's thread but someone responded with a useful suggestion to my first post on it. We are concerned about how much trouble DC is having at school and we are taking it seriously. He is 4 and it is not a public school. Can someone actually recommend a developmental pediatrician? The initial therapist was actually someone the school recommended. He is a psychologist but I have no idea how I would know what he is and is not qualified to diagnose? This process may seem intuitive to those of you who have been immersed for a while but for those of us just getting started, it absolutely is not.
Call up Children's and Kennedy Kreiger Institute and get on BOTH their waiting lists. It will be at least 6 months unless you get on the cancellation list. You can always cancel the other appointment.
The fastest way to get an educational evaluation is to contact your local Childfind and ask to get your child evaluated. This evaluation will usually be done within 60 days. Call today.
Do both. Get on the waiting list for a private eval and call Childfind.
That would be overkill if it really is just one teacher. We are going through something similar and instead of going all out on evaluations, we are addressing the behavioral issue directly. If necessary we will bring in additional in-school resources to help do an observation. Luckily the behavior seems to be dying down and the teacher has retracted her over-reaction. With such a young kid and so early in the year, it makes sense to consider whether the teacher and normal adaptation to a new class are the issue. Obviously we wil keep a close eye on things, but as a parent you are certainly not obligated to take the most intensive measures for every possible problem.
Most of the people on this board whose kids have ADHD or ASD/Asperger's got their kid evaluated at the suggestion of a teacher in preschool so this is to be expected.
Every year around this time there are a bunch of parents who come to the SN board asking for advice bc their kid's school flagged issues. Getting your child evaluated by Childfind is not overkill if issues are suspected. If there are issues and you put off getting an eval, you are only putting off getting your child help. Getting on the waitlist at Children's and KKi now is not at bad idea either. If it's not needed, you can always cancel but if your child needs to be seen, it's a LONG wait.
Anonymous
10/09/2015 10:04
Subject: neuro-psych evaluation --does it always equal a diagnosis?
Anonymous wrote:Even if there is no significant diagnosis they may put one down in the report so you can get some insurance reimbursement. If they find nothing wrong, no reimbursement. Almost anyone, including us, can be put inder PDD-NOS so that is one catch all. Sloppy writing? Got it covered -- motor skills. Etc.
Jeez no, I would never push for my child to get a misdiagnosis so his diagnostic procedure can be covered by insurance. PP you are the person people are talking about when they get worked up about people mislabeling their child.
Anonymous
10/09/2015 10:01
Subject: Re:neuro-psych evaluation --does it always equal a diagnosis?
Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:OP,
Stop hiding the ball. How old is your kid and what kind of "therapist" screened him/her. You can't do a quick screen for ASD or ADHD. You can do checklists that might point to concerns but that's not definitive. Talk to your health insurance and find out what is covered. If money is truly an issue, NIH has clinical trials all the time. The screenings are free if your kid qualifies.
You're "skeptical" but you haven't done any of the heavy lifting. You've sought out a therapist of some kind for some reason. Your pediatrician cannot diagnose ASD or ADHD. If those are your concerns, you need to bite the bullet.
+1 You can ask your public school for an evaluation. It will be a psychoeducational evaluation but it will not cost you anything and if it highlights any issues you can schedule your child for a private neuropsych at your cost or ask for an independent educational evaluation which the school system will pay for.
But if the teacher is raising concerns, it'll be well worth it to investigate whether your child needs help instead of dismissing the teacher's concerns because you don't think there is a problem. Obviously, your child is having "problems" at school.
How old is your kid?
I am 22:12 and also 23:51. I am NOT OP and I am not sure why there was a need for such nasty responses (mostly the one two above)? We are not dismissing the teacher's concern. To the contrary, we are pressing ahead even though EVERYONE else is telling is the problem is the teacher (hence the skepticism). I did not mean to hijack OP's thread but someone responded with a useful suggestion to my first post on it. We are concerned about how much trouble DC is having at school and we are taking it seriously. He is 4 and it is not a public school. Can someone actually recommend a developmental pediatrician? The initial therapist was actually someone the school recommended. He is a psychologist but I have no idea how I would know what he is and is not qualified to diagnose? This process may seem intuitive to those of you who have been immersed for a while but for those of us just getting started, it absolutely is not.
Call up Children's and Kennedy Kreiger Institute and get on BOTH their waiting lists. It will be at least 6 months unless you get on the cancellation list. You can always cancel the other appointment.
The fastest way to get an educational evaluation is to contact your local Childfind and ask to get your child evaluated. This evaluation will usually be done within 60 days. Call today.
Do both. Get on the waiting list for a private eval and call Childfind.
That would be overkill if it really is just one teacher. We are going through something similar and instead of going all out on evaluations, we are addressing the behavioral issue directly. If necessary we will bring in additional in-school resources to help do an observation. Luckily the behavior seems to be dying down and the teacher has retracted her over-reaction. With such a young kid and so early in the year, it makes sense to consider whether the teacher and normal adaptation to a new class are the issue. Obviously we wil keep a close eye on things, but as a parent you are certainly not obligated to take the most intensive measures for every possible problem.
Anonymous
10/09/2015 09:50
Subject: Re:neuro-psych evaluation --does it always equal a diagnosis?
Anonymous wrote:Anonymous wrote:Anonymous wrote:OP,
Stop hiding the ball. How old is your kid and what kind of "therapist" screened him/her. You can't do a quick screen for ASD or ADHD. You can do checklists that might point to concerns but that's not definitive. Talk to your health insurance and find out what is covered. If money is truly an issue, NIH has clinical trials all the time. The screenings are free if your kid qualifies.
You're "skeptical" but you haven't done any of the heavy lifting. You've sought out a therapist of some kind for some reason. Your pediatrician cannot diagnose ASD or ADHD. If those are your concerns, you need to bite the bullet.
+1 You can ask your public school for an evaluation. It will be a psychoeducational evaluation but it will not cost you anything and if it highlights any issues you can schedule your child for a private neuropsych at your cost or ask for an independent educational evaluation which the school system will pay for.
But if the teacher is raising concerns, it'll be well worth it to investigate whether your child needs help instead of dismissing the teacher's concerns because you don't think there is a problem. Obviously, your child is having "problems" at school.
How old is your kid?
I am 22:12 and also 23:51. I am NOT OP and I am not sure why there was a need for such nasty responses (mostly the one two above)? We are not dismissing the teacher's concern. To the contrary, we are pressing ahead even though EVERYONE else is telling is the problem is the teacher (hence the skepticism). I did not mean to hijack OP's thread but someone responded with a useful suggestion to my first post on it. We are concerned about how much trouble DC is having at school and we are taking it seriously. He is 4 and it is not a public school. Can someone actually recommend a developmental pediatrician? The initial therapist was actually someone the school recommended. He is a psychologist but I have no idea how I would know what he is and is not qualified to diagnose? This process may seem intuitive to those of you who have been immersed for a while but for those of us just getting started, it absolutely is not.
Call up Children's and Kennedy Kreiger Institute and get on BOTH their waiting lists. It will be at least 6 months unless you get on the cancellation list. You can always cancel the other appointment.
The fastest way to get an educational evaluation is to contact your local Childfind and ask to get your child evaluated. This evaluation will usually be done within 60 days. Call today.
Do both. Get on the waiting list for a private eval and call Childfind.
Anonymous
10/09/2015 09:37
Subject: neuro-psych evaluation --does it always equal a diagnosis?
^PDD-NOS no longer exists as a diagnosis per the DSM-V.
Anonymous
10/09/2015 09:18
Subject: neuro-psych evaluation --does it always equal a diagnosis?
Even if there is no significant diagnosis they may put one down in the report so you can get some insurance reimbursement. If they find nothing wrong, no reimbursement. Almost anyone, including us, can be put inder PDD-NOS so that is one catch all. Sloppy writing? Got it covered -- motor skills. Etc.
Anonymous
10/09/2015 09:15
Subject: Re:neuro-psych evaluation --does it always equal a diagnosis?
Anonymous wrote:Anonymous wrote:OP,
Stop hiding the ball. How old is your kid and what kind of "therapist" screened him/her. You can't do a quick screen for ASD or ADHD. You can do checklists that might point to concerns but that's not definitive. Talk to your health insurance and find out what is covered. If money is truly an issue, NIH has clinical trials all the time. The screenings are free if your kid qualifies.
You're "skeptical" but you haven't done any of the heavy lifting. You've sought out a therapist of some kind for some reason. Your pediatrician cannot diagnose ASD or ADHD. If those are your concerns, you need to bite the bullet.
+1 You can ask your public school for an evaluation. It will be a psychoeducational evaluation but it will not cost you anything and if it highlights any issues you can schedule your child for a private neuropsych at your cost or ask for an independent educational evaluation which the school system will pay for.
But if the teacher is raising concerns, it'll be well worth it to investigate whether your child needs help instead of dismissing the teacher's concerns because you don't think there is a problem. Obviously, your child is having "problems" at school.
How old is your kid?
I am 22:12 and also 23:51. I am NOT OP and I am not sure why there was a need for such nasty responses (mostly the one two above)? We are not dismissing the teacher's concern. To the contrary, we are pressing ahead even though EVERYONE else is telling is the problem is the teacher (hence the skepticism). I did not mean to hijack OP's thread but someone responded with a useful suggestion to my first post on it. We are concerned about how much trouble DC is having at school and we are taking it seriously. He is 4 and it is not a public school. Can someone actually recommend a developmental pediatrician? The initial therapist was actually someone the school recommended. He is a psychologist but I have no idea how I would know what he is and is not qualified to diagnose? This process may seem intuitive to those of you who have been immersed for a while but for those of us just getting started, it absolutely is not.
Anonymous
10/09/2015 09:02
Subject: neuro-psych evaluation --does it always equal a diagnosis?
We had a neuropsych done at CNMC and I was actually expecting a few things to show up in their findings that they mentioned but said they couldn't definitively diagnose. They seemed pretty conservative to me in their findings. Maybe you should try there. We also had it covered by insurance.
Anonymous
10/09/2015 08:51
Subject: neuro-psych evaluation --does it always equal a diagnosis?
You are the parent. You can be the recipient of misdiagnoses for your child, but still do what you think is right - decline recommended therapies, decline or ask for specific meds, accept or decline educational options. there is nothing about going to a doctor or neuropsych for evaluation that means you will have to DO anything you don't think is correct.
Educate yourself. There is so much available online now, you can also do research on your child's issues, but just be careful to stick to reputable sources.
I write as a parent who has dealt with misdiagnoses of a family member; in the field of mental health, misdiagnosis is not infrequent. I also have a child with a language disorder which is frequently misdiagnosed as something else.
I would do a neuropsych eval. More information is helpful, even though you might not agree with some overall conclusions or recommendations.
Educate yourself. There is so much available online now, you can also do research on your child's issues, but just be careful to stick to reputable sources.
I write as a parent who has dealt with misdiagnoses of a family member; in the field of mental health, misdiagnosis is not infrequent. I also have a child with a language disorder which is frequently misdiagnosed as something else.
I would do a neuropsych eval. More information is helpful, even though you might not agree with some overall conclusions or recommendations.