BiPolar (BP), neuropsychologist etc

[miles2go]

So my 8 y.o. son has a BiPolar (BP) I diagnosis. I might have questioned it more if it wasn't obvious in his mom (also hypomanic much of the time with some nasty mixed states) and family history with alcoholism, rages, and suicide. His 10 mg of Ablfy barely keeps him out of trouble in school, but he's obviously also hypomanic much of the time, and psychiatrist can reluctantly ramp him up to 12 mg but no more. People on this board are big on neuropsychologist evaluation. When I brought it up with the psychiatrist he didn't see a reason to, since brain damage was not an issue.
Any opinions?

 

[smallworld]

The one reason I might push for a neuropsychologist evaluation is because BiPolar (BP) can carry co-morbid learning disabilities, and these need interventions of their own. Without knowing about them, you can't address them. There's a whole chapter about neuropsychologist evaluations in the book The Bipolar Child that you might find interesting.

 

[gcvmom]

Does the psychiatrist talk about adding a MS to the mix? It seems to be rare that someone with BiPolar (BP) can find stability on just an AP alone.

As for the neuropsychologist evaluation, it can help sort out if and how the psychiatric issues are impacting the learning process, which very often it does. And they can recommend supports for the school and home environment.

 

[timer lady]

neuropsychologist evaluations aren't the end all be all however they tend to give us a map, if you will, of the treatment/services needed for our difficult children.

I'm sorry psychiatrist wasn't able to see past text book reasoning for ordering this evaluation. It's frustrating.

 

[miles2go]

Thanks, smallworld. I'll bring it up again with psychiatrist. difficult child is obviously academically strong when in controlled environment, that's why -- another subject -- school district is suggesting moving him from a class of mixed age/need Special Education class from where he visits with some success genrl ed class (math, skips "humanities") and with less success recess, art/music/PE to the district's special "emotionally challenged" school with counselors, smaller classes etc. The schools reviews look good enough -- any suggestions what else I should look at?
Me - married dad.
difficult child 8y.o. Son, BiPolar (BP)

 

[smallworld]

Miles, I'm not sure what you're asking. Can you clarify your question?

 

[totoro]

K tends to run Hypo and in a mixed state most of the time with Psychotic episodes and hallucinations.

The neuro-psychiatric evel in my opinion, helped us first off with figuring out what type and how bad her ADHD symptoms are, whether or not it is true ADHD or a symptom of BiPolar (BP)?
We figured out she has a Learning Disorder. We saw how bad her inattentiveness was affecting her actual IQ. And her work in class. We saw why she could not write and why she had a hard time reading....
Lots of little things even though she was still ahead of her class mates.

At around 8 years/3rd grade a lot of our kids can start to slip in school. Especially if they do have learning disorders. They tend to be very smart and have held it together, but the issues they have catch up with them as things get harder and they can't keep track and keep the mess in order in their brains. Focusing on everything becomes harder.
Sometimes the chaos becomes too much, unless they have someone that understands and is aware that these things are going on or may come up.
This year K's Learning Disability (LD) has started creeping up on her even though she is still ahead of most of her class on some things. Most teachers would think she was doing OK, besides her ADHD symptoms and writing issues.
But the neuro-psychiatric evaluation has caught the issues. We can track them and are seeing them happen. It just explains so much more about our kids, whether the psychiatrist wants to see it or not.
It showed speech issues as well.

We also have a better IEP now. Because of it.

 

[confuzzled]

--cut---
This year K's Learning Disability (LD) has started creeping up on her even though she is still ahead of most of her class on some things. Most teachers would think she was doing OK, besides her ADHD symptoms and writing issues.
But the neuro-psychiatric evaluation has caught the issues. We can track them and are seeing them happen. It just explains so much more about our kids, whether the psychiatrist wants to see it or not.
It showed speech issues as well.

We also have a better IEP now. Because of it.

i guess, to answer op's question, no, a neuropsychologist workup will not definitively diagnose BiPolar (BP), unless there is something i really don't know. (think about it, if that kind of testing could diagnosis, that would be the FIRST course of action in suspected BiPolar (BP), Know what I mean??). it IS however, useful in identifying underlying needs and deficiencies, and particularly helpful to identify education needs. i'd vote for doing it if you possibly can....

we are at the same place as totoro and her difficult child...

(in fact, she was scheduled for today, and i canceled for now)

we are pursuing neuropsychologist testing for exactly the same reason, and to identifiy similar type issues and to write a stronger iep. my difficult child has done the educational portions in the past and they would have been moderately useful if i had an outside opinion, vs just thrown at me from the school with no reccommendations. but now i know better

same deal with mine....she's an academic superstar, and all teachers say she's doing more than ok. maybe next to the rest of the population, but certainly not what her intelligence tells us she's capable of. for a host of reasons, some due to the school themselves, to ME its obvious there are issues that are impacting her learning. some of her issues will hopefully resolve with stablization, some probably wont, and she will need accomodations to manage.

but i can also tell you our psychiatrist has zero interest in it as well, he's made it clear that its not going to change his diagnosis, and i understand what he's saying.

but its worth the $$$ for me to help her in any way i can...

 

[miles2go]

smallworld -- sorry to have been cryptic, I think I was texting while walking or driving or something. The district is suggesting (or planning to suggest) moving him to another, specialized school and I am just wondering what I should consider.

Totoro, thanks, always value your input. And thanks to all of you -- I think I am convinced to try and get a referral from psychiatrist. I think he's open to it -- he actually asked me to float his attitude on this forum (I mentioned to him where I get my neuropsychologist ideas) to see what responses will be. He does see some attention deficit in difficult child but when I asked him how much it is a product of BiPolar (BP) and how much is independent he saw no way of knowing.

 

[nvts]

Thanks, smallworld. I'll bring it up again with psychiatrist. difficult child is obviously academically strong when in controlled environment, that's why -- another subject -- school district is suggesting moving him from a class of mixed age/need Special Education class from where he visits with some success genrl ed class (math, skips "humanities") and with less success recess, art/music/PE to the district's special "emotionally challenged" school with counselors, smaller classes etc. The schools reviews look good enough -- any suggestions what else I should look at?
Me - married dad.
difficult child 8y.o. Son, BiPolar (BP)

Hi! I would make sure that I knew their policy on restraining the child when there are meltdowns, how often they get to see the therapists, and I would insist on visiting the school to view their time out/safe zone locations and what the methodology is for using them.

I found it interesting that he's good in math but skips humanities. I'm not questioning Bipolar for a diagnosis, but am curious if he might have a touch of Aspergers (sorry - I know I sound like a broken record!) going on as well. If the Abilify isn't helping and if he's gotten worse with adhd medications, you might want to spin the suggestion past the neuropsychologist and psychiatrist. They (bipolar and aspergers) can run co-morbidly as well.

Sorry for the quick suggestion - it's recycle night and the kids are running late for bed - - AGAIN!

Beth

 

[miles2go]

Asperger's? Don't know much about it but I kinda doubt it -- he's ok at math and not so bad with humanities, but given that he has behavior problems in the larger group he goes only for what's more important as instruction and does his other work (incl reading and writing) in the spec class. No problems with eye contact etc.
But comorbidity is an interesting question.