Evaluations ON medications?

[Elise N. T.]

My 9yo DS is having evaluations done at a psychiatric/neuropsychologist place Monday. He has an ADHD diagnosis right now. His teachers think he may be Obsessive Compulsive Disorder (OCD) or on the autistic spectrum. The psychiatric says he's pretty sure the ADHD diagnosis is right but that there's something else in addition to that, and I agree with him. I think we've tried every major ADHD medication out there and nothing has been consistent for him. I'm also fairly sure he has sensory disorder but the psychiatric said they did not have the time to test for that and Molina would not pay for it. I'm fairly sure therapy for the sensory issues wouldn't be covered either so getting him the official label would be a bit useless, right?

Anyway, on to the real question...

I called and asked if they wanted him on or off his medication (vyvanse) for the testing. The receptionist said he should be on medications. I asked if she was sure because they are testing how his brain works and it works differently on medications. She said yes, he should still be on medications.

Does this make sense to anyone? How will they see his behaviors properly when he's doped up? His medications right now are too strong in the middle of the day and don't work past school hours. They completely change his personality - from tasmanian devil to shy quiet hyperfocused child who won't talk. Shouldn't they be testing my REAL son? I don't get it.

Should I give him the medications like they said? Take him off medications and ask when I get there if I should give them to him? Give them to him in the parking garage so they can see the real him for the first hour or two and the medicated him for the other five hours?

Good news is that they will be referring us to a p-doctor after testing who will work with him to find good medications since we've had so much trouble with them. His pediatrician just pushes whatever's on his latest desk calendar from the pharmaceutical companies.

UPDATE: he had his evaluations today. I gave him his medications right before we left the house so he would be a little more hyper in the morning and they could see both sides. More questions about sensory issues and school districts in post nine!

 

[SRL]

If the receptionist requested that you bring him in on his usual medications then I would do that and also bring in a video of him flying his true colors so the diagnosticians can see the contrast.

While seeing a kid in tasmanian devil mode may be very enlightening, it won't be conducive for getting him through the kinds of testing they are probably planning for that day. Also, much of assessment relies on parent interview so be ready to explain the difference between him on medications and off.

If your son has sensory disorder it is very important that it is recognized and treated to whatever degree you can afford or arrange for. Sensory Integration Disorder (SID) can really throw a curve into everything for kids--at the very least he should have an assessment done through the school district. I wouldn't just assume that it wouldn't be covered as we had one insurance company that did and another that didn't--inquire to be sure.

 

[smallworld]

I'll disagree slightly with SRL's response. The receptionist may not know and the doctor should be consulted. (However, the testing is Monday so you may not have time to ask the doctor beforehand.) When my son was tested a year ago, his neuropsychologist had us bring in the ADHD medication and gave it to him an hour into the testing. THe neuropsychologist wanted to see if the ADHD medication made any difference in his abilty to focus (it didn't -- and he's no longer taking ADHD medications).

Good luck with the testing.

 

[BusynMember]

We had ten hours of testing. My son was on his medications because they couldn't be withdrawn quickly, but the neuropsychologist still got a really good look at my son's abilities. Of course, he did VERY extensive testing and spent a lot of time with my child. Not all NeuroPsychs test, in my opinion, long enough or extensively enough to make good diagnosis. I'm not sure it matters if the kids are on or off their medications.

 

[Christy]

My son was on his medications. during the neuropsychologist. I think it is necessary to get a true picture of the education aspects of testing; however, on the flip side, my son thrives on one-on-one attention and having adults as a captive audience so they all thougt he was delightful when he is an absolutely different person in the presence of his peers. Still, I don't think any of the testing would have been valid without the medication and the type he is taking would have needed to be tapered down for awhille before testing and this would have been disasterous on a day to day basis.

I do think your point is valid though and is worth discussing with the doctor.

 

[smallworld]

My son also took his other mood-stabilizing medications while being tested by the neuropsychologist (they, too, would have had to have been weaned for several weeks beforehand). However, ADHD medications are different and can affect the attentional parts of the testing. That's why it's important to run the medication issue by the doctor before the testing begins.

 

[klmno]

If there is concern that something else is going on besides adhd, I wonder if they are looking at it like he should be on adhd medications while being tested so they can see what areas he's struggling with outside of the scope of adhd. Or, what areas are the adhd medications NOT helping with?

 

[totoro]

When K had her Nuero-psychiatric done, she had yet be medicated. The doctor was blown away by how a child could "Move" so much and yet still focus, answer questions and be in the moment!
She was literally on his table while being tested, upside down, taking her clothes off... making noises, distracted!
But she answered every question!!!
For us I think this helped him "see" that it wasn't just ADHD... she was doing other things as well.
Later when K was tested by the SD, she was medicated... she was "clearly medicated" they saw nothing, her IQ was lower, their testing procedures were
not as thorough as the Neuro-psychiatric.
So they thought she was fine. She was a little zombie...
I have had Doctors say leave her medicated others say no...
I like the idea of the video, we always bring a copy. I also bring a list of (parent report) of symptoms that brought me to the doctor.
Most Neuro-psychiatric's can filter out these things and should listen to you! Our's was able to see a lot of things others, less trained could not. Even sensory things!!!
Good luck

 

[Elise N. T.]

If your son has sensory disorder it is very important that it is recognized and treated to whatever degree you can afford or arrange for. Sensory Integration Disorder (SID) can really throw a curve into everything for kids--at the very least he should have an assessment done through the school district. I wouldn't just assume that it wouldn't be covered as we had one insurance company that did and another that didn't--inquire to be sure.

How would I go about getting the school district to do an assessment? He has an IEP and a 504 for his ADHD. He tested out of speech therapy a year ago. He gets one-on-one time with a Special Education teacher for a little bit every day, although she herself admits she has no idea what to do with him because he is ahead in his school work so she just lets him work on his current obsession.

He has an IEP meeting next month. Do I ask them to assess him for sensory issues? Or ask for occupational therapy? If he has Sensory Integration Disorder (SID) are they required to give him therapy for it?

He most definitely needs it. I just got a copy of his records from when he was 2 1/2 and his therapists noted sensory issues and suggested continued occupational therapy. He never got that because the school he went to only had physical and speech therapy. I really wish I'd known back then what sensory issues were but no one ever explained it to me and I didn't have the internet.

He gets attached to a certain pair of pants and refuses to change them for days because all the other pairs feel bad and bother him. Then when we wash the favorite pants and give them back he won't wear those because he's become used to the ones he has on. He never wears socks without a huge tantrum because they don't feel right. All tags must be cut out of shirts. He has a high tolerance for cold. Loud noises and bright lights terrify him (it is for this reason alone he has to go under general anesthesia for dental work). He constantly brushes against walls and crawls/spins/rolls on the floor.

 

[SRL]

For years I bought 6 pair of the same pants, same color. Ditto with shorts. Same style tshirts and sweatshirts in different colors. All socks and underwear identical. It makes it much easier for them because it feels the same everyday. I highly recommend Lands End.