Hope this is not a stupid question!

Discussion in 'General Parenting' started by lovelyboy, Dec 31, 2011.

  1. lovelyboy

    lovelyboy Member

    After my other posts on getting more help for my son......I was wondering:
    Is there a difference between a psychiatrist and neuropsychiatrist?
    My son was diagnosed by a psychiatrist......if I want more investigation do I take him to a neuropsychiatrist or neurologist?
    Whats your thoughts on second opinions? How do I go about doing this? Do I tell the second dr that I want a second opinion? Because some dont like the idea? Do I say who the first dr was (because I trust her and dont want to talk bad)....
    Do I say what the current diagnosis of previous doctor is? Because obvious the new doctor would want to know who put him on the medications and why......I cant pretend we havent been down this road before? Because I dont want to stop his medications....
    Do I ask the first dr that I would like more investigation and would like to see a neurologist?

    Any advice would be great thanx!
  2. InsaneCdn

    InsaneCdn Well-Known Member

    Second opinions? How about 4th and 5th? Sometimes, it takes that long to get answers.
    However. You can't always get these back-to-back. Specific tests can only be run 3-4 years apart.

    Having said that - it depends on...
    1) how much testing was actually done
    2) the kinds of details you have in your parent report (you are working on one, right?) that are not answered by the original diagnosis
    3) the gaps in accommodations, interventions and medications - the unmet needs.

    We had major testing re-done 3 years after the first... and got partially better answers.
    Two years later - difficult child goes completely off the cliff.
    We fought for a re-evaluation, but they can't re-do the testing... so, a PHD level psychologist "reviewed" the prior testing, and then added more tests that had not been done... and the result was significantly closer (still not complete).

    We had cooperation between 2nd testers and 3rd tester... and still do, even though #3 challenged #2's interpretation of test results!
  3. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Neuropsychs do specific testing in all areas of a child's function. Usually the testing goes on from 6-10 hours. I trust nobody as much as a neuropsychologist. If you need to also see an Occupational Therapist (OT) or PT, you can get a referral from him, but he often can sort out problems in those areas himself, along with speech, LDs, ADHD, autism spectrum, IQ, performance ability...you name it. A good neuropsychologist is extremely thorough and you, as the parent, also have to fill out a ton of forms. Hub and I both had to fill out three long, long questionaires and one teacher had to fill out one too. It took him three weeks to study the findings and write them down. He broke down my kid in a way nobody else ever had and he "got" him more than anyone else did as well.

    Frankly, his psychiatrist had been a bad apple and a waste of time, diagnosing him wrongly with bipolar. I still get angry when I think about his three years with the wrong diagnosis and a ton of medications.

    Anyhow, you have my very biased opinion...lolol. It took us a long time to get the full picture because issues become clearer as the kids get older. We had an update about every three years. Every neuropsychologist, without reading what the other had said, diagnosed him on the autism spectrum. He is. And he is medication free and he most certainly does NOT have bipolar...grrrrrrrrrrrrrrrrrr! He has life challenges, but he is NOT moody!!!! :)
  4. lovelyboy

    lovelyboy Member

    Ok....this is what has been done:
    We as a family went to talk to psychiatrist.....she asked as a ton of questions.....for 30 min, with kids in the room, wanted to observe dynamics......then she interviewed me and hubby for 20 min alone.....asked more questions....then had an interview with difficult child for 10 min alone.....
    I wrote her plenty of background and other info that I thought she needed to know.
    She saw us for more follow up sessions...getting info and feedback.....then after that she made a diagnosis of high functioning autism with anxiety and Obsessive Compulsive Disorder (OCD) traids.
    He had propper Occupational Therapist (OT) and ST assessments.....both said that his profile fits Autism Spectrum Disorders (ASD).....SI problems and some auditory and other speech issues.....
    The psychiatrist isnt very interested in IQ testing...says she doesnt want to overload him...that he is doing extremely well at school....when he develope problems that might indicate IQ it can be tested.....I want testing to be done for TLE....she says its ok, we can do it.....but I can see she isnt concerned about this being a problem.
  5. svengandhi

    svengandhi Well-Known Member

    A neuropsychologist is certified and trained in both neurology and psychiatry while a psychiatrist is not. If you want to try to find a cause, I'd go with a neuropsychologist, if you want talk therapy and medications, a psychiatric is better.
  6. buddy

    buddy New Member

    A neuropsychologist is not a medical doctor. NOT an MD. NOT someone trained in neurology and psychiatry. They are PhD psychologists with additional training in neurology and how behavior and the brain are connected. They generally do not do therapy. They can not prescribe medications though they can refer for a medication evaluation if they think it is helpful just like any psychologist can.

    A neuropsychiatrist is an MD and is trained in neurology and psychiatry. Their emphasis is on working with people who have neurological problems that cause behavior and psychiatric conditions. They do prescribe medications if needed. Just like many psychiatrists, they may not do the talk therapy part of things.

    A neurologist, specifically an elileptologist, is the MD doctor who can best look at seizures. They are MD neurologists who focus seizures in their practice. This is the kind of doctor that was a break-through for us.

    Q uses our beloved pediatrician (who has developed a specialty in working with behavior disordered kids inc Autism Spectrum Disorders (ASD), ADHD, BiPolar etc..in thier clinic) as the main filter to make sure anyone else we go to does not contradict a plan from another doctor's plan. He is also the backup if there is an emergency with medications or whatever if the specialist in charge is not available for some reason. He directly communicates with our neurologist monthly at least and they have attended conferences together and they are not even in the same cities....over 45 minutes apart...but they are just that good.

    Our neurologist is our main support for his issues. Though we now have added her friend who is a psychiatrist because she has more expertise in the types of medications that the pediatrician and neurologist have chosen. She is really the one that I communicate with the most. She totally gets it and knows who to send us to when needed for other information. She really listens to Q and values my input on EVERYTHING. Well worth the effort to look for someone like that if you can find them. (in whatever field, just I mean the values she has) Both our neurologist and psychiatrist have kids with special needs....

    I dont know what is available where you life. If you were here I would suggest the epileptologist and neuropsychologist. That is just MHO.

    I agree neurppsychs (neuropsychologists) do the best overall testing but when the testing for language and motor only involve subtests of bigger tests....it can only be considered a screen and or and indication if more testing could be helpful. You would be surprised at small number of questions that they use to determine if language is a problem or not. Sometimes they will use a full language testing protocol and then you can get a better picture. Just make sure you know if they are talking about subtests or full tests.... It does not rule out motor, sensory or language problems. I have received neuropsyc evaluations that suggested no language or communication issues when the in depth testing I had done (usually along with knowing the child for a long time which of course is always a super important piece that is really under valued) showed there was definite problems. It is really important to use common sense. No matter how good a person is in testing, nothing replaces how well you know your child. The fact is that any testing like the standardized IQ tests, language tests, etc. reflect how the person does on that day...there are times when kids really are having a health issue that makes the results not as valid or reliable. Other times a child may be able to perform well under those ideal testing conditions but they dont do well in the real world. THAT is why the parent/caregiver/teacher forms and the history forms are so very very important.

    If any doctor says they are not comfortable with a second or third opinion...they should be fired. That is pure arrogance and not helpful to you or your child. doctors should WANT more information and WANT to get to the bottom of things.