What professional to see?

[wiroots]

I am the mother of a 14-year-old newly ADHD diagnosed son with some previous mood disorders (which seem to be improving), but want to nail down support and consider medication ( I am struggling to be ok with the med path and know if it's the right one). In a nutshell, I'm trying to understand where to go next.... Neuropsych? A developmental pediatrician? Psychiatrist? What's the difference? He was diagnosed by his primary care doctor, and she said she is comfortable treating him, but her evaluation wasn't comprehensive (only parent and child surveys), and I am looking for a more thorough analysis before considering medication. I would also love to stay under insurance when possible. And all this with a kiddo who rejects any type of help, especially medical professionals. Any advice would be appreciated. Thank you!

[Knitting20projects]

Probably the soonest appointment will be with a child psychiatrist covered by your insurance. That will likely still be a wait. Developmental behavioral pediatricians are in short supply and typically have long waiting lists. A comprehensive psychological assessment with testing will not be covered by insurance unless there are concerns for possible autism and your child has symptoms that can justify a diagnostic evaluation for autism. Those also usually have waiting lists. IQ and learning disability and executive functioning evaluations (done by a child psychologist or pediatric neuropsychologist) are not covered by insurance ever in my experience and are around $2000-3000. I hope this helps a little!

[BVBV]

My son currently is unmedicated but he received a very thorough physical and mental evaluation by a Pediatric Neurologist that specialized in ADHD.

[Knitting20projects in reply to BVBV]

Yes, depending on the pediatric neurologists in your area this may be an option. In my area they’re mostly academic (affiliated with the medical school) and don’t do ADHD management and long term treatment. Some in your area may. In my area the wait is a year, unfortunately (my other child is on the waiting list for evaluation of a different issue). Hopefully you’re in an area with better access 💕.

[BVBV in reply to Knitting20projects]

So sad! Yes I was able to easily book an appointment with a specific Dr with little wait time.

[FitsInNoBox]

We did a Neuropsych evaluation -- it was partially covered by insurance, but like others have said, it took over 9 months between the wait list and multiple evaluation days, etc, and was also very expensive. I'm not sure it was worth it. We came away with a report but I haven't seen it make a huge difference in treatment.

My only advice is do what you and your son feel works for you. At one point, we were seeing an occupational therapist, psychiatrist, therapist and pediatrician. So many weekly appointments triggered my son's (12) anxiety and seemed to make things worse. Additionally, they all seemed to give conflicting advice that made me feel overwhelmed and awful as a parent because I could not possibly implement all of the suggestions, since some directly contradicted each other (For example, his OT suggested he needed to stick with extracurriculars to help with motor and social skills, but his therapist said that the one activity my son had agreed to was making him miserable and I should stop 'forcing it'). After all of that, an optometrist diagnosing a previously unknown vision disorder made the biggest difference.

We now see only the psychiatrist about every 3 months for medication management. We know we can always call other offices if we need to or specific questions come up. Personally, for us, too many specialists was not a good fit. I would try a psychiatrist to discuss medications and go from there, but be open to making changes or dropping "services" altogether if they aren't helping.

[Knitting20projects in reply to FitsInNoBox]

Yes, I agree that it can reach a point of overwhelm and impossibility. We have 2 kids with ASD & it feels impossible trying to manage their needs, especially since they can only attend therapies/appointments after school. And 1 has lots of homework. I pick and choose what we can manage without sending my 13 year old son into a tailspin.

[anirush]

We started medication with our pediatrician. But he admitted he could only go so far he was not a specialist. So we now see a child psychiatrist.The medication route was determined by how my child was doing in school, and what misbehavior or being inattentive was doing to his self esteem and grades.

He has been on medication since kindergarten and is now seventeen. Don't think we could have managed life without medication.