Neuropsych not neuropathy … that was an autocorrect

Anonymous wrote:

Anonymous wrote:What are the evidenced based therapies for anxiety? People always say do your research. But I’m not a scientist. I don’t understand what research papers say.

I just posted but according to our psychiatrist meds + therapy. (True for adults too)

OP here - so would this be anxiety medication in addition to ADHD medication? Seems like a lot at once. And the dr who performed the neuropathy is hopeful treating the ADHD will largely address the anxiety.

As a parent of a high functioning autistic/adhd child who is now 10 but was diagnosed of having autism around age 2. Here’s what I have learned:
1. It’s a marathon and not a sprint
2. Don’t give up the dreams that you have for your child, that means prioritizing his/her and your family’s overall well being.
3. List them for Medicaid waiver. You may be on the list forever but in case something happens it may be an option.
4. If possible, both parents should continue to work full time and save for retirement
5. Sign up for able account for your child
6. For therapies, there is a lot out there but some of it is just not evidence based. So, knowing what your child needs is the best way to tease out what the specific needs are. If you got a neuropsych, ask the provider what the priorities are to focus on 1 year from now, 3 years from now and 5 years. This will help you get clarity.
7. If you are not in healthcare, use reputable online resources to gather information, this will help to again tease out what may help or not.
8. Have faith and good luck

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It’s insane. We make a good living and our parents still cover the therapies for our adhd kid because they’re so expensive. I think about this all the time.

For what it’s worth, I’m not sure how much any of the therapy helps at a young age. Medication has been by far the most helpful thing. I would probably hold off on anxiety therapy until they’re older and can apply it. And OT we did for two years… it helps some but really for my child’s motor skill delays and adaptive skills that he was delayed in, not much for emotional regulation.

Agree with you on the limited use for OT … for therapy though, actual evidence-based therapies for anxiety will not drag on. They are time limited and may be worth investing in. Evidence based therapies also focus on the parent not the kid.

The evidence is strongest for kids w/ generalized anxiety is therapy + meds. It is absolutely worth doing early because you can actually rewire the brain as the younger the are, the more plasticity there is.

OT is a mixed bag based on people I have talked to. We did it for three years and motor planning and coordination improved immensely, but it was extremely incremental and only the cumulative effects were noticeable over a long period of time. Our insurance covered it once we hit our deductible but if finances or time were an issue, this is one I might skip. I think lots of outside time in nature (climbing trees, playing in the dirt) over time would be a good (free!) substitute.

I’m not sure about the plasticity claim, or the meds you are talking about.

OT for us had a very big initial benefit (child with poor motor planning went from not being able to play to being able to climb ladders on play structures, etc) but the biggest benefits were in the first year. After that money was better spent on 1:1 sports coaching.

Why do claim that there isn’t evidence for therapy/meds? We’ve had many professionals say similar things and a quick search confirms PP claims:

Evidence for meds and therapy: https://www.aafp.org/pubs/afp/issues/2022/1200/

Plasticity evidence, strong corrrlation across 28 studies: https://journals.sagepub.com/doi/10.1177/2514183X20974231#:~:text=Twenty%2Deight%20studies%20employing%20seven,in%20child%20and%20adolescent%20samples.

And for other question re: evidence based therapy, that usually means time-bound, goal-oriented programs like CBT or DBT, not just talk therapy.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It’s insane. We make a good living and our parents still cover the therapies for our adhd kid because they’re so expensive. I think about this all the time.

For what it’s worth, I’m not sure how much any of the therapy helps at a young age. Medication has been by far the most helpful thing. I would probably hold off on anxiety therapy until they’re older and can apply it. And OT we did for two years… it helps some but really for my child’s motor skill delays and adaptive skills that he was delayed in, not much for emotional regulation.

Agree with you on the limited use for OT … for therapy though, actual evidence-based therapies for anxiety will not drag on. They are time limited and may be worth investing in. Evidence based therapies also focus on the parent not the kid.

The evidence is strongest for kids w/ generalized anxiety is therapy + meds. It is absolutely worth doing early because you can actually rewire the brain as the younger the are, the more plasticity there is.

OT is a mixed bag based on people I have talked to. We did it for three years and motor planning and coordination improved immensely, but it was extremely incremental and only the cumulative effects were noticeable over a long period of time. Our insurance covered it once we hit our deductible but if finances or time were an issue, this is one I might skip. I think lots of outside time in nature (climbing trees, playing in the dirt) over time would be a good (free!) substitute.

I’m not sure about the plasticity claim, or the meds you are talking about.

OT for us had a very big initial benefit (child with poor motor planning went from not being able to play to being able to climb ladders on play structures, etc) but the biggest benefits were in the first year. After that money was better spent on 1:1 sports coaching.

Anonymous wrote:What are the evidenced based therapies for anxiety? People always say do your research. But I’m not a scientist. I don’t understand what research papers say.

yeah I am sorry, I always throw that term around. For kids, evidence based anxiety therapy will focus on how the adults in their lives can make sure they are not reinforcing anxiety and that they are supporting the child in learning to tolerate anxiety. This takes the form of time-limited skills-based therapy - the best known is called SPACE. https://www.spacetreatment.net/

Non-evidence based therapies and interventions for kids are often very costly because they have no end point and no focused goals, and because they are not effective. That’s things like ill-defined 1:1 talk therapy with a child.

With respect to school interventions, almost all of the interventions people talk about here are expressly non-evidence based and are actually bad for anxiety because the focus on letting the child escape from anxiety. if there is a single hallmark of evidence-based treatment for anxiety, it is that avoidance perpetuates anxiety. So things like letting a child skip oral presentations, extended testing time, letting child skip school and then make up missed assignments … all are very counterproductive.

Anonymous wrote:

Anonymous wrote:It’s insane. We make a good living and our parents still cover the therapies for our adhd kid because they’re so expensive. I think about this all the time.

For what it’s worth, I’m not sure how much any of the therapy helps at a young age. Medication has been by far the most helpful thing. I would probably hold off on anxiety therapy until they’re older and can apply it. And OT we did for two years… it helps some but really for my child’s motor skill delays and adaptive skills that he was delayed in, not much for emotional regulation.

Medication can be great, but wait as long as you can and try to find a med that doesn’t exacerbate the anxiety.

Depends on how deregulated or how much they are suffering. Theres no reason to wait for meds if your child is struggling.

Anonymous wrote:What are the evidenced based therapies for anxiety? People always say do your research. But I’m not a scientist. I don’t understand what research papers say.

I just posted but according to our psychiatrist meds + therapy. (True for adults too)

Anonymous wrote:

Anonymous wrote:It’s insane. We make a good living and our parents still cover the therapies for our adhd kid because they’re so expensive. I think about this all the time.

For what it’s worth, I’m not sure how much any of the therapy helps at a young age. Medication has been by far the most helpful thing. I would probably hold off on anxiety therapy until they’re older and can apply it. And OT we did for two years… it helps some but really for my child’s motor skill delays and adaptive skills that he was delayed in, not much for emotional regulation.

Agree with you on the limited use for OT … for therapy though, actual evidence-based therapies for anxiety will not drag on. They are time limited and may be worth investing in. Evidence based therapies also focus on the parent not the kid.

The evidence is strongest for kids w/ generalized anxiety is therapy + meds. It is absolutely worth doing early because you can actually rewire the brain as the younger the are, the more plasticity there is.

OT is a mixed bag based on people I have talked to. We did it for three years and motor planning and coordination improved immensely, but it was extremely incremental and only the cumulative effects were noticeable over a long period of time. Our insurance covered it once we hit our deductible but if finances or time were an issue, this is one I might skip. I think lots of outside time in nature (climbing trees, playing in the dirt) over time would be a good (free!) substitute.

What are the evidenced based therapies for anxiety? People always say do your research. But I’m not a scientist. I don’t understand what research papers say.

Anonymous wrote:It’s insane. We make a good living and our parents still cover the therapies for our adhd kid because they’re so expensive. I think about this all the time.

For what it’s worth, I’m not sure how much any of the therapy helps at a young age. Medication has been by far the most helpful thing. I would probably hold off on anxiety therapy until they’re older and can apply it. And OT we did for two years… it helps some but really for my child’s motor skill delays and adaptive skills that he was delayed in, not much for emotional regulation.

Agree with you on the limited use for OT … for therapy though, actual evidence-based therapies for anxiety will not drag on. They are time limited and may be worth investing in. Evidence based therapies also focus on the parent not the kid.

Anonymous wrote:

Anonymous wrote:OP here and so far we have done everything out of pocket through providers who don’t submit to insurance. Her pediatrician was useless when we shared the issues DD is having so we got a recommendation from her school for a provider to do a neuropsych and paid out of pocket.

It’s hard but find OTs and therapists covered by your insurance. It took some time and we had to drive a little farther, but we ended up paying a fraction of what we were paying out-of-pocket. It is absolutely worth it.

Each year more and more healthcare professionals in the area stop taking insurance. As a result, the waiting lists for those who still take insurance get longer and longer. It's a real problem.

Anonymous wrote:It’s insane. We make a good living and our parents still cover the therapies for our adhd kid because they’re so expensive. I think about this all the time.

For what it’s worth, I’m not sure how much any of the therapy helps at a young age. Medication has been by far the most helpful thing. I would probably hold off on anxiety therapy until they’re older and can apply it. And OT we did for two years… it helps some but really for my child’s motor skill delays and adaptive skills that he was delayed in, not much for emotional regulation.

Medication can be great, but wait as long as you can and try to find a med that doesn’t exacerbate the anxiety.

Anonymous wrote:It’s insane. We make a good living and our parents still cover the therapies for our adhd kid because they’re so expensive. I think about this all the time.

For what it’s worth, I’m not sure how much any of the therapy helps at a young age. Medication has been by far the most helpful thing. I would probably hold off on anxiety therapy until they’re older and can apply it. And OT we did for two years… it helps some but really for my child’s motor skill delays and adaptive skills that he was delayed in, not much for emotional regulation.

Oh and another vote for getting what you can through the school district. It’s not as good as out of pocket therapy but it’s something - especially depending on what the OT issues are (if things like handwriting and pencil grasp, it will be helpful through school district. Sensory integration not as much.)

It’s insane. We make a good living and our parents still cover the therapies for our adhd kid because they’re so expensive. I think about this all the time.

For what it’s worth, I’m not sure how much any of the therapy helps at a young age. Medication has been by far the most helpful thing. I would probably hold off on anxiety therapy until they’re older and can apply it. And OT we did for two years… it helps some but really for my child’s motor skill delays and adaptive skills that he was delayed in, not much for emotional regulation.