Does the SD have to

[klmno]

provide/pay for and allow an IEE if a parent requests it due to inaccurate information given in the sd's psychoeducational report and due to that report completely focusing on diagnosis's that have never been given by any other professional? And these aren't diagnosis's pertaining to Learning Disability (LD)'s. Or does the parent even need to justify that request? Can I ask (and get) the IEE from a licensed "clinical psychologist"? She has a PhD in psychiatric (the lady who did this sd evaluation) but is licensed as a "school psychiatric". I checked our state regs and found that clinical psychs are licensed to include "Diagnosis and treatment of mental and emotional disorders" but this is not listed under the practice of a licensed school psychiatric.

My son has had diagnosis's as follows: Depression and Disruptive Behavior, Bipolar 1, Adjustment Disorder with depression and disturbance of conduct, Mood Disorder, not otherwise specified. He has had rule-outs of ODD and 3 years ago had a rule-out of CD. These diagnosis's came from 3 child/adolescent psychiatrists and 1 neuropsychological report. I don't think they are out of whack wwith my son's history or the family history or even with each other.

This person, who is a educational psychologist for the sd, decided that my son shows signs of depression sometimes "based on previous reports" but she focuses on CD as a primary concern and says he is Social Maladaptive (is that even a diagnosis?) and has anti-social tendencies because he will "do anti-social things if he thinks it will impress peers". Basicly, she's saying he has an Axis II diagnosis and gives no weight to an Axis I diagnosis.

She mentions that the one psychiatrist ruled-out BiPolar (BP), but didn't mention that the same psychiatrist also ruled out CD in the same report and said that she thought it was Adjustment Disorder with secondary acting out due to stressors. She said difficult child had "many evaluations in the past with differing diagnosis's", however, I view those diagnosis's along the same lines and find it hard to believe that they (we) are that off-base and the problem all along has just been that difficult child was a bad kid and I'm in denial about it. Then she's recommending what therapy difficult child and I should have outside of school and what "community supports" and monitoring he should get at home and in the community for his CD. She is an educational psychiatric- if there are more quallified people involved, should she be doing this?

She also "found" that he scores average in everything except he had very low scores in visual and verbal/audio memory but even though those were low on his tests in 2006 and they have gone down since, she attributes it to some outside noise going on during the testing.

Can I get an IEE because of this? If you get an IEE does it have to be with another psychoeducational person who does nothing but want to report "bad behavior" to a school? This is a real issue here since the Cho incident.

 

[ML]

I don't know the answer but I am always in your corner to support you K... Love ML

 

[DammitJanet]

Ok, I am going to devils advocate here. For several months now you have been saying you dont even know if you believe that the bipolar or mood disorder diagnosis is the right diagnosis and you have been wanting them to remove the medications while in Department of Juvenile Justice. This would lean towards this psychiatric report being correct in removing the Bipolar1 and Mood Disorder not otherwise specified diagnosis from his Axis 1. Now she did do the depression test and it showed signs of that so that should still be there. I can understand why she has the CD and the signs of anti-social behavior in this report. He has performed acts and has the criteria for these diagnosis's. Sorry...it just is the truth. He is in Department of Juvenile Justice. At least 80% have to meet this criteria.

The visual and verbal memory scores being low shouldnt be discounted though because of noise. If there was noise, she should have done them again. Personally I dont think noise would have made a difference. I just hoovered at it no matter what.

And...all CD kids or people with Anti-social tendencies arent destined to be another Cho. People know this. They dont lump all kids who have had problems into a pot and say they are going to be mass murderers. That is a one in a million chance.

 

[klmno]

Thanks, ML!

Ok, difficult child has been evaluation'd by a total of 6 psychiatrists (if you caount the ones from the phosps) and one clinical psychiatric over the past 3 years. Five diagnosis's were in the mood disorder category and one was adjustment disorder. Several had disruptive behavior listed as a secondary diagnosis. The trial off the medications was to help determine which mood disorderr or if it was adjustment disorder because everyone who had dealt with difficult child seemed to agree it was along those lines and the bad conduct was a result, not the cause. Also, if difficult child is BiPolar (BP), then this should clarify and help get the sd and legal authorities on board with it.

The educational psychiatric approached this in the report like the primary problem is CD with a secondary intermittent depression. I somehow can't wrap my brain around her being right and all the other profs being wrong just based on her report when the report had errors in areas of background info and left out certain facts- like she picked and chose which facts to include but both were equally important, she chose the ones that supported the "he's just a bad kid" position. And when she's an educ psychiatric who works for the sd, not a clinical psychiatric.

It might turn out to be correct, but it's going to take more than this one report by her before I accept it.

difficult child was a basketcase yesterday. As it turns out, they did discuss the absence of lithobid for several days with the psychiatrist and he told them to just take difficult child off of it, so he went cold-turkey off the lithobid. I don't know if it is recent stressors or the sudden removal of lithobid meaning he is BiPolar (BP) or meaning his brain is just adjusting to the sudden removal instead of having it titrated but he was clearly having stability issues so I called the tddoc this morning and just got off the phone with her. She's going to talk to him today and call me back. Also, it could be a good thing if this opened the door to them being able to access difficult child therapuetically. Anyway, at least it is starting to reveal what I see and hear at home, whatever that turns out to be.

I think things still could end up with people getting more on the same page. The educ psychiatric said she had not consulted difficult child's therapist- the Department of Juvenile Justice therapist who he's seeing now- and she seemed surpprised that I asked if the therapist could come to the iep meeting to review the report. It seems odd to me that the evaluation would not have taken the opinions/assessments of the therapist into consideration if the educ evaluation is trying to cover/question a diagnosis for mental illness and make recommendations for future therapy outside of school. Also, I read reports from a couple of others on the IEP team and they are not entirely consistent with the findings of this educ psychiatric. One was reporting on school progress now and says difficult child behaves well but does have weaknesses in verbal skills and organization and planning- this is reported from those actually at school. Another says that difficult child tries hard and gets along well with others but does exhibit enough emotional difficulties necessitating extra supports through an IEP. Those seem to be consistent with other findings- it just seems to me that the educ psychiatric report is the "odd ball" so I can't see assuming that it's the correct one.

I don't think there is ANY question in any other mental health prof's mind that something besides poor behavior is intermittently going on with difficult child and it's apparently becoming evident to those working with difficult child in school, too. This situation now with difficult child being unstable might shed some additional light. The therapist asked what I thought about continuing to leave difficult child off lithobid and I asked her to evaluation that and help determine if difficult child's current state was adjustment to medication removal (temporary), a good thing allowing therapuetic work, or an indicator that difficult child is definitely BiPolar (BP). Of course, this will have to be looked at for a few days or maybe a couple of weeks and discussed with the psychiatrist. I'm going to put a lot more confidence in what they say than iin what the educ psychiatric said. She saw difficult child a couple of hours one day, then a couple of hours on another, went thru his sd record and apparently only glanced at info I provided and the Department of Juvenile Justice record of charges. That's it.

When the therapist calls back today, I think I'll tell her about the results of this report and see if she's in agreement.

 

[smallworld]

I think -- but I'm not positive (where are Martie and Sheila when you need them?) -- that you absolutely do not want these labels on a report for the SD because then your difficult child does not have to be guaranteed FAPE. Can you check around www.wrightslaw.com? Can you check in with a sped attorney? Can you get a free advocate? I would think you need an IEE at the very least.

 

[Shari]

I didn't think the school could diagnosis anything, but I'm not sure. My brain seems to be on vacation.

In Missouri, there is an organization called MPACT - that can help you sort out what schools can and can't or should and shouldn't do...perhaps you can contact them to see if a similar organization exists in other states? Heck, they may be able to help you with the question.

 

[klmno]

Good point, SW! Thanks! I would think that if the Department of Juvenile Justice therapist is not in agreement with the findings that an IEE should be granted- especially since this school is on a Department of Juvenile Justice faacility for these kids committed to the state only. Now, difficult child's regular therapist is a regular, typical therapist and might put some weight on this report, however, she has a higher up who is a phD level clinical psychiatric. In this state, the clinical psychiatric is the highest, even if the educ psychiatric has a phD. I feel certain that the clinical psychiatric will disagree with CD as the primary diagnosis.

 

[klmno]

That bugged me, too, Shari after I read what licensed educ psychiatric's were qualified to do in our state. It does not list diagnosis'ing or treating psychiatric illnesses so who is she to basicly discredit it? She puts in the report that the BiPolar (BP) diagnosis is disputed but does not add that the question is "is it BiPolar (BP) or unipolar depression or adjustment disorder", even though she has documentation from psychiatrists stating those diagnosis's. There are several suspoicious things- she lists things that will cause a "shock factor" to school personnel when difficult child returns to mainstream but does not list that he had NO significant behavior problems at school for the past 2 years. She lists some things saying difficult child said them but difficult child swears he didn't (ok- that IS questionable to me- she might be right), then she says hhis Department of Juvenile Justice record indicates "a major aggressive incident with another child outside of the school setting", however, difficult child NEVER had a charge or even legal accusation about something like that. How could something like that be in his Department of Juvenile Justice record (which is the record from legal charges, detention, and probation) and me not be aware of it? I've never even gotten any report that difficult child had a major aggression incident with another kid outside of school or in school. He did have pushing matches and a couple of fights where one or two punches were thrown and he was written up at school but it was listed as "no injury" and the last one was over a year ago after a boy threw difficult child against a locker and held him there by his neck, so difficult child punched him in the stomach. The PO even excused that- but difficult child was not arrested for it. That's why I think it's a biased report.

Plus, if she's not allowed to provide therapuetic treatment with this license, should she be making recommendations on what type of therapy difficult child and I should get for a diagnosis she came up with?

I think this is still all about which side is going to win- the mental health profs and me or the sd and legal people- in determining what is causing difficult child to do the things he does and what treatment is best for it. I'm approaching it like I want to make sure everything is thorough and complete so everyone can get on the same page and work together to do what is in difficult child's best interest and offer him the best hope for rehabilitation. I keep reminding the PO that if the legal people are going to order mental health treatment, then they need to be on board with what those profs say and be supportive of it as well. But the type of therapy should be per the mental health prof's recommendations, not dictated by legal authorities or the sd.

 

[JJJ]

"socially maladapted" kids don't qualify for Special Education. You want that phrase out of there.

 

[klmno]

Thanks ladies! you are a blessing! I found our state regs for requesting an IEE. I have to state my reasons in general but don't have to be specific. I am going to request one based on the fact that the report is not consistent with findings of other professionals and, although I don't know hhow to word this yet, it only includes facts that support her primarily CD position and not the other facts. For instance, one state expert ruled out BiPolar (BP) saying she thought it was Adjustment Disorder and she also ruled out CD in the same report. This educ psychiatric puts in her report "Dr. XX ruled out BiPolar (BP)" but does not include that Dr. X also ruled out CD and gave difficult child the adjustment disorder diagnosis and said it was because difficult child's behavior was a result of identifiable stressors perceived stressors that he had trouble processing and that he had poor coping skills. Nope- this lady listed only "BiPolar (BP) was ruled out".