Finally got the evaluation report

[Shari]

Had to go wait in the office for an hour for them to find it, sign it, copy it, etc...but hey, I got it.

"difficult child is a 6yo boy with-longstanding history of severe behavioral difficulties which has resulted in multiple diagnosis. difficult child exhibits severe impulsivity, hyperactivity, poor attentional regulation, executive functioning deficits, and an atypical pattern of attachment. While his symptoms do not appear to warrant any additional psychiatric diagnosis at this time, the severity and duration and significant family history place him at extremely high risk for further problems. Therefore, intensive intervention across home, school, and community settings is warranted at this time." it goes on to cover his hypersexual behaviors and points out the times he wanted to cut his penis off, etc...details reasoning behind attachment disorder.

His language/speech is low; processing speed is borderline; expressive and receptive language was low; cognitive functions is borderline; social skills are below average, multiple sensory issues, executive functions are impaired except for planning and organizing, organization of materials, and initiative (go figure).

Several pages are then dedicated to interventions recommended, including 2 pages of the importance of a 1:1 in the public school setting, including the playground.

Official diagnosis resulting from all this is adhd.

I'm tired. Will process it tomorrow.

 

[witzend]

That pretty much leaves me speechless. I certainly hope that you and your family will be able to get the help for difficult child that he needs. What a long road ahead you all have! "The longest journey..."

{{{{{{{{{{Big hugs}}}}}}}}}}

 

[LittleDudesMom]

Wow Shari,

lots of information to process. With the length of the report and the description of issues, it is suprising that the only diagnosis is adhd. But perhaps, given difficult child's age, it is bet to treat the symptoms and see what effect interventions will have in moving him forward.

You can take comfort in that the evaluation included interventions for school and therapy. It gives you a place to start, a beginning for healing and moving forward. Now comes the work, implementing the plan, working with the school to get the 1:1 and other accoms in place in his IEP.

As overwhelming as it appears to you now, take some comfort from the plan. Hugs.

Sharon

 

[SRL]

I'm speechless too.

 

[smallworld]

Shari, do you get an opportunity to go over the report with the evaluators? We always have feedback sessions following neuropsychologist testing so we can ask questions and understand the test results and dxes. My number one question for these evaluators: How can all those symptoms be attributed to ADHD? Doesn't something else have to be going on with this child?

 

[SearchingForRainbows]

Shari,

I just want to let you know I'm thinking about you. It definitely takes lots of time to process a report like the one you just received. Take it slowly... Don't feel like you have to grasp all of it at once. Whenever I get a new evaluation, I'm always overwhelmed at first. I think it's important that you try to get a bit of time to yourself while taking in all of the information you've just received.

Sending lots of hugs and caring thoughts... WFEN

 

[BusynMember]

In spite of how hard it is to get a neuropsychologist report, if the only thing he comes up with is "ADHD" I'd want another opinion. Something sounds very "off" to me. As for attachment issues, that's theory. I dont know. Maybe just go for the interventions, but that will be hard to do if your only diagnosis. is ADHD. Strange. (((Hugs)))

 

[Nancy]

Gosh Shari, all that could have been written about my difficult child too. I don't look at this as only an ADHD diagnosis. It is the one they can somewhat concretely identify for insurance purposes and even possibly treat with medication. I have had my difficult child evaluated three seperate times and not once did they ever give a diagnosis that seemed to cover everything going on with her, instead they call it not otherwise specified mood disorder. But they too identify symptoms of attachment problems, impulsiveness, behavioral problems, ODD, language problems, etc. Children who have severe behavioral issues mostly all have a variety of symptoms. It's frustrating I know, because I too wanted a diagnosis I could see that coevered everything, something to treat, something that wrapped all her behaviors up in one package. The problem is that just doesn't happen.

Your difficult child is only six. Over the coming years he is going to change so much, some behaviors will get better, some may get worse, new ones will most certainly come up. That's why it is so utterly exhausting for us parents and why we are so frustrated that there doesn't seem to be any way to fix it.

The most helpful part of this report is: "Therefore, intensive intervention across home, school, and community settings is warranted at this time." Hopefully this therapist has some ideas on how you can accomplish this. We have often said that it is taking a village to raise our difficult child and that is literal. We had to put in place interventions across the board for her with very little help from anyone. At least this therapist seems to recognize that is necessary so hopefully he will have some ideas on how you can accomplish that.

MWM I continue to wonder why it is that every single person that every gets the diagnosis of anything that has anything to do with attachment problems you negate it, but seem to jump at other diagnosis that you promote.

Nancy

 

[witzend]

I read it as a diagnosis of ADHD and attachment disorder. Did I read it wrong? Smallworld has a good suggestion of a debriefing with whoever did the neuropsychologist.

 

[Shari]

I'm speechless, too. And yes, Witz, you read it right - the diagnosis from this evaluation is ADHD and attachment disorder (along with the sensory stuff he already had, etc).

The attachment thing makes me so very angry that I even gave DEX a chance. Granted we're not talking full blown Reactive Attachment Disorder (RAD) here, but still, this shouldn't be here at all. I've got some (justifiable) anger to process there. Seems so far fetched that 6 or 8 hours a day for a few months is enough to do this, but I can't deny that the shoe fits...just...hurts that I let that happen.

I'm relatively happy with the extent of recommendations. Of the 20 pages, 4 FULL pages are dedicated to recommendations. Actual useful ones this time. I've made some calls and have some additional behavioral support services interviews set up. Next will be funding them, but I'll figure that out, too.

As for follow-up, I have a direct phone number for questions. If nothing else, the severity of his problems are seen now. I think I have their attention, and I think they are willing to help now.

I still don't see that ADHD covers all thsi without stretching it a lot (what adhd kid is good at organizing and initiating??? or becomes obsessed with 100 piece puzzles...? Or head bangs and hand-flaps everywhere he walks???) But I don't care what they call it so long as they give me useful information and recommendations to deal with it. They did agree he qualified for behavioral services in the autism center with or without the autism diagnosis and they backed off the initial preliminary report idea of having the school provide all these services for him. That would never happen.

I've requested our in-home therapist back. The interview for additional behavioral supports is being scheduled. I'm going to start looking for a PCA type person. I've made 8 copies of the report and mailed it out this morning to his various providers. Not exactly sure where to go next, but this is a start. There's a psychologist they've recommended that I still need to contact, but I may look for one closer to my work and his school. Then again, I like to keep "the team" together, so...gotta decide which way to go on that.

Not what I hoped to hear, but its a good place to start. NO WHERE in there do they recommend medication changes or even medications as an alternative. VERY glad about that. I think we'll need medications, maybe even new ones, but the focus of medications as the fix has been shifted. That was my goal.

Sorry, I'm rambling. Still processing it all. Thanks for the support. Sorry I'm not giving much back right now. I love you guys.

 

[SRL]

http://www.cdc.gov/ncbddd/adhd/

Shari, were they willing to do the bloodwork for Fragile x?

 

[TerryJ2]

Holy cow. ADHD after all that? Come ON.
Well, the good news is that you do have recommendations. Take a deep breath and take a break. Poor little guy. Poor you.
{{{hugs}}}