Eval - neuro pediatrician or extensive academic / psych testing

[wearetryingourbest]

Hello,

My son was diagnosed with ADD very young- preschool. He’s managed OK up until now that he’s in seventh grade and the demands are greater at school and at home. I’m unsure of where to have him reevaluated….the neuropsych / neuro pharmacologist that’s recommended spends an hour with him as opposed to going to a doctor that would conduct extensive academic / psych testing over three days. What has everyone done here and what do you recommend? I’m unsure of the right path….

He does not like to go to school cannot sustain attention to study for a long periods of time and is not being responsible around the house with keeping his room clean and showering, going to bed on time, etc. and yells at me whenever we ask him to do any of this. Unlike my older son, he never had tough behaviors like these in the past so, I would imagine the expectations are getting too great. Ferling so badly as he’s one of the youngest in his grade and I should’ve given him the extra year when he was in preschool but now it’s too late for that. Any advice is greatly appreciated.

[Mamamichl]

I would go through the doctor that does the extensive over 3 days. My stepkid did it that way and we learned so much more about how his brain works than my daughter who did a quick eval.

[wearetryingourbest in reply to Mamamichl]

Thank you, really appreciate your feedback!

[artistmomMe]

Hi!

Your story sounds very familiar. My daughter was diagnosed with ADHD and depression in 7th grade. When the world started demanding more from her, she really struggled. Homework, projects, and life became overwhelming and the depression set in hard. We enrolled her in EF coaching which helped but the demands were too much.

It was suggested that she see a neuro-psychologist and we did our research to find the best. It was a lot of money out of pocket but the testing and final report was outstanding. The testing took 2 afternoons (it's intense.) We discovered that our daughter has a very high IQ but her processing is really very slow. She was also diagnosed with high functioning ASD which now explains a lot. Her 504 has been upgraded to an IEP.

This is our story and I guess my point is that you should put in the effort to find the right neuro-psychologist. We had considered another doctor for insurance reasons but it became very clear she was not the right one and I'm SO thrilled we didn't go with her. I know in my heart her evaluation would have lacked the subtle nuances that some neuro-divergent kids present (especially females.)

Good luck!

[wearetryingourbest in reply to artistmomMe]

Thank you. I hope your daughter is doing / feeling better. The pediatric neurologist we were referred to is highly regarded. I was surprised to hear he doesn’t do extensive academic testing. I know he’s one of the best, but I don’t understand how they can learn enough about a child in one hour. I think I will take your advice and look for someone that does the full battery of academic testing. I actually did that many years ago with my older son. it was very expensive and took three days. at the time you could either do psychological testing or academic.

Were they able to help your daughter? I hope she’s feeling better.

[Knitting20projects in reply to wearetryingourbest]

A pediatric neurologist will not do academic tests because they don’t have that training. They will do a medical evaluation for things like seizure disorders, ADHD, autism, Tourette syndrome, some genetic disorders that can look like an intellectual disability or seizure disorder, etc. If they think a full diagnostic evaluation for autism is needed because they’re not quite sure if a child has it, they would refer out to someone else. If they think extensive educational or neuropsychological tests are necessary, they will refer to a pediatric psychologist, educational psychologist, or neuropsychologist depending on the exact concerns. Physicians do not get trained in the extensive testing for those disorders. I hope this helps! It’s a confusing landscape for families, I know.

[Knitting20projects]

Agree with longer duration evaluation. This sounds like executive function weaknesses but could there also be mood or anxiety issues? Autism? I don’t know, but definitely will take more than 1 hour to figure out. I cannot imagine any professional sorting this situation out adequately in 1 hour. —pediatrician here

[Onthemove1971]

I am curious about what assessments have been done in school.to support your son? These usually lead to an IEP, 504 plan or no services, has that been a path you have explored? There are a few advantages to this. 1. It's free 2. It supports the need for educational and social emotional support in the school. We're there recommendations when he was first diagnosed for your son, which could help?

Hope you are able to get what helps your son.

[wearetryingourbest in reply to Onthemove1971]

He has an IEP with modifications. He must need more …

[Onthemove1971 in reply to wearetryingourbest]

You could start by calling an IEP, as soon as possible and see what the team suggests..

[wearetryingourbest]

Good idea. I met with his team of teachers for school conferences but not sure why I hadn’t thought of that. Thank you!