My difficult child's appointment with pediatrician. Psychologist

Discussion in 'General Parenting' started by SunnyNC, Mar 4, 2007.

  1. SunnyNC

    SunnyNC New Member

    Continued from my post about my difficult child's experiences with his Dr appts......

    The next day we had our appointment with the pediatrician. psychologist. Let me tell you, this was the most horrible experience I have ever had in my life with a Dr. My husband went with me to this appointment as well. Our appointment was scheduled for 1pm and when the office called to confirm, they wanted us to come in 15 minutes early to fill out paperwork. We arrived at 12:45, but other than ourselves, there was NO ONE in the office! My husband had to be at work by 3pm and has a 1 hour commute. We were told that the appointment would last an hour. Ten minutes after 1, we finally hear voices in the back of the office, we assume they have been at lunch. Nope....a lady appears in the reception area with a client at the check out windown paying for her visit. I go to the glas partician window and the lady opens it and apologies but their staff has Friday's off!?!? She hands me a clipboard with a few papers on it and says, I am not sure these are all the papers, but if they are not, (Dr. name) will give you the missing forms. Uhhh....

    I fill out the 4 pages...none of which ask for any sort of information at all. Nothing that even included billing information like my address. All of them were just release forms that I just sign my name at the bottom and date.

    About 10 minutes later (now approaching 1:30) I tell my husband, you don't have to stay if you can't...he has to get to work afterall! He said, no that he would stay...phew! The Dr. comes to the lobby and calls us back. Now...all this time, I am ASSUMING that since I made an appointment with a pediatrician. Psychologist office that I would see a Psychologist...wouldn't you? We get to her office, we sit in the chairs, my son sits on the couch and the Dr sits at her desk in a chair. She then introduces herself as a Physician's Assistant. WHAT? At this point, I am like...whatever, as long as you can help me and get the testing scheduled, I don't care who you are.

    She asks my son how he is doing, he says fine...she says "Groovy." This apparently was her favorite word as she said it MANY times haha! She asks difficult child a lot of questions; who lives at home, pets, church, very basic questions which I figured she would ask. Then she turns to my husband and I and asks us several basic questions, including medical history. I tell him family (not immediate) history of clinical depression (my mom), ADD (my brother), and Asperger's Syndrome (not diagnosed...my husband's brother). She DID have my approx 20 pages of the Parent Assessment which I put in a binder including copies of my son's IEP from school when he had speech. She did say that she did read through it, but admitted she had not read it all. I was just glad she actually read any of it! :smile:

    She asks my husband and I what specific event brought us here. So I explained the major blow up with my neighbor my son had (see my original post). She turned to my difficult child (9) and asked him what happened. My son starts to cry and explain his side of the story. This was very upsetting for me to see as I knew he was not comfortable telling this very emabarrassing story to someone he had never met before. She says to him...that must have been very scary for you...I see where this is going and stop it. I said look, we have been friends with these neighbors for almost 8 years now. We have cookouts, our kids play together etc. It was not until my neighbor told him to stop piling on top of his children in a game they were playing which resulted in their daughter crying out she couldn't breathe...that difficult child threw his tantrum resulting in the blow out. She at this point asks my son if he would mind waiting in the lobby while she talks with my husband and I. Mind you...there is NO ONE in this office besides my family and the Dr...but she is going to have him go wait in the empty lobby. Hindsight I would have thought about this.

    She then proceeds to tell my husband that he has classic ADD. Now, my brother rememeber had ADD as a child and struggled with it VERY badly in school. My son is a straight A student, in a special gifted class learning algebra and analogies. She said his world is incredibly overstimulating for him and that she had tried to make eye contact with him at least 40 times and he was not able to make eye contact with her. I Said..RIGHT!!! That is possibly Autism!!!! She said, no I don't see any autism in him. I work with autistic and Asperger's kids and they are just not there when you talk with them. They are lost in a world of their own and he is just not in any way autistic. I show her the pictures from preschool of the vetical lines. She says, he did that because that was something he could control in his overstimulated world. I told her about his food issues dating back to when he was weaned from baby food. She said that was his way of controlling us and others. I said, so a 2 year old can have the mindset to do something like this, even to at 9 years old today? Even though he gags and physically gets sick when trying anything new. She said ohhh yes! (her game was up by this point in my book, I knew she was dead wrong..certainly some kids might do this, but I can NOT imagine to the extreme this child is). I did try to "catch her" so to speak and asked her....does an ADD child typically have problems with reading out loud and sounding robotic and skip words even though their reading comprehension is 3 grade levels above where they currently are? She did admit at that point that no, there could also be a neurological aspect to this as well.

    She said she can give him some medication that will calm his world down for him and not make things so overwhelming for him so he can make better decisions without shutting down. I said my husband and I were Adamently against medicating this child. She said...well what if you had diabetes? I stopped her before she went on.... I said look, I am NOT against the use of medication; my husband is on thyroid medications, I am on blood pressure medications. I AM against the use of medications as a first line of defense when we do not even know what is going on with him! She said she agreed with me at this point. Talk about having to go on the defensive...thanks "doctor."

    From there the appointment was just no longer productive because she didn't want to hear anything really that the neurologist was concerned about...she had made her "diagnosis" probably before we walked into the room by reading whatever parts she had read in that Parent Assessment/Report. She recommeneded councelling sessions with the psychologist so he can learn to make better choices. She did say that we should go ahead and have any testing done, but never suggested that their office could do the testing.

    My husband left for work as I was trying to check out...they of course could no take any sort of payment because the office staff was not there and the PA didn't know how to do that. I have no idea how they are going to bill me without any sort of billing information! I went home and as I was driving home with my son, he said....Mom, you know why I was upset when I was telling the story? Of course I am DYING to hear what he has to say since the PA suggested he was afraid of my neighbor. He said...because I was frustrated and didn't want to talk about it. I told him that was perfectly okay and thanked him for telling me. I felt so bad for him for being put in that position at all.

    I called the neurologist office and they will call me Monday to refer me to a Neuropsycholgist for the testing he desperately needs.

    I will keep everyone posted...I am sorry this got so long. My husband called me when he got to work by the way....he was just as frustrated with the entire appointment as I was although he was pretty quiet the entire time. I was very relieved as until that phone call, I didn't know how he felt. I am happy to know we are on the same page. :smile:

    Have a great day!
    Rachel
     
  2. house of cards

    house of cards New Member

    I totally understand your frustration. I am sick of doctors that discount what you tell them and think they are getting a clearer picture of your difficult child in the 30-60 minutes they see them. And to not even be the actual doctor...grrr, although I would probably be open to an assistant if they could really relate with us.
     
  3. DammitJanet

    DammitJanet Well-Known Member Staff Member

    Well that wasnt helpful!

    I dont remember getting the impression from your first post that your son had ADD. Normally Im pretty good at picking up on that having lived with it.

    Hopefully the testing can get to the bottom of what is going on with your son and you can help him. As far as medications go, I have heard that some Autism Spectrum Disorders (ASD) kids do well on some medications to help some symptoms but it is individual. The doctor will work with you on that when you know more.
     
  4. SunnyNC

    SunnyNC New Member

    Yep...she felt he had classic ADD because of the no eye contact. That his eyes were on everything but her when he was talking with her and when she talked with him. She said that he is so overstimulated by everything in his environment and that is when she went off on the ADD and "control" tangent. My husband and I knew that was not it, because he can sit down and draw a VERY detailed picture of a car (like on fast and furious)for 35 minutes straight...yes I timed him after this Dr appointment! He does not have any problems in focusing in this aspect! :smile: hehe My mom, who is a nurse, and had to deal with my brother who was diagnosed young with ADD said stick to your guns, there is no way he is ADD. Hopefully the testing will give us a better picuture of what we are dealing with. I am NOT beyond medication IF it helps him lead a more "normal" happy life. But I sure was not ready to jump on the drug bandwagon she was trying to deal us.

    Have a great day!
    Rachel
     
  5. DammitJanet

    DammitJanet Well-Known Member Staff Member

    I dont even get where she thinks that ADD kids want to control. My ADHD kid was so not into controlling us. He wanted to please us in the worse way. He still does. That just doesnt make sense to me. Jamie was just not a behavior problem really. He could do normal kid things that were wrong but what kid cant? He was simply impulsive and goofy and so active you couldnt keep him still. He still wears me out when I am around him for any length of time.
     
  6. Sheila

    Sheila Moderator

    I would NOT be happy to arrive at such an appointment and be interviewed by a PA. I'm glad you are pursuing a proper evaluation.

    <div class="ubbcode-block"><div class="ubbcode-header">Quote:</div><div class="ubbcode-body">because he can sit down and draw a VERY detailed picture of a car (like on fast and furious)for 35 minutes straight. </div></div>

    Your son's ability to focus in this manner does not rule out ADHD. Most ADHD kids can hyperfocus -- that just can't do it 24/7.

    The problem you are seeing is called Selective Attention.

    Selective attention. This means a child goes from one extreme to another, showing the ability to intensely concentrate, or "hyperfocus," on something he enjoys doing, something he is good at or feels is relevant or interesting, yet becomes inattentive and tunes out things he finds routine or boring. While all children have difficulty concentrating on boring tasks, the child with ADD finds it nearly impossible. These children focus inappropriately. For example, send a child on an errand to his room to get something and he may get sidetracked watching a bug on the wall and forget why he was going upstairs in the first place. Or a child may focus on a bird playing in the tree outside rather than what the teacher is saying in the classroom. Again, this is more of a difference than a disability. The key to managing your child with ADD is to turn the possible liability into an asset. For example, because of the ability to hyperfocus (become extremely attentive to something that holds his interest), try to match the child with ADD to the task. For example, when I coach Little League baseball, I put the ADD child as pitcher, catcher or at first base where they have to pay attention. Never put a child with ADD in the outfield where he doesn't have to focus and can watch the birds and airplanes and truly be "out in left field." Veteran hockey team managers have long realized the value of positioning the child with ADD as a goalie because of their ability to hyperfocus. http://childrentoday.com/resources/articles/addp1.htm

    My son IS classic ADHD. He could have been the poster child for this definition. by the way, our difficult child can also "sit still" and draw very detailed stuff. It's mind boggling how disorders can impact our kids.

    There are different types of ADHD. It takes a professional to sort it all out. ADHD may not be the problem at all. There are a lot of same symptoms that can be found on lists for various disorders.



     
  7. TerryJ2

    TerryJ2 Well-Known Member

    Oh, Rachel! How frustrating! It's good for me to read things like this so I remember to ask specific Q when making an appointment.
    So sorry you now have to make yet another appointment. to see your way through this.
    I can kind of see where the eye contact issue thing would come in, but after reading your posts, I think Aspberger's is a distinct possibility.
    Good luck! I'm sending good vibes your way.
     
  8. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    I can tell you first hand that the psycologist is wrong about Aspergers and Pervasive Developmental Disorder (PDD)-not otherwise specified. My son has it and I'm in a group of parents and kids with Autism Spectrum Disorders (ASD). Many seem quite alert, some have even learned to make eye contact. They are not always "in their own world." My son is so much better now that nobody would ever guess he's on the Spectrum and I'll bet that psycologist would say he has ADHD too. See the neuropsychologist. They know more about the Spectrum. Sorry you had such a bad experience. I had one psycologist (I really don't like regular psycologists, in general) who told me in front of my four year old son, "There's not much you can do about THESE kids" as if my son couldn't understand him just because he had a speech delay. I still have fantasies of finding him and punching him in the nose. I wonder what this psycologist thinks autism looks like because it looks very different depending on the child. Aspie kids tend to have very high IQ's, but are socially clueless.
     
  9. Marguerite

    Marguerite Active Member

    Autistic kids also desperately ant to control their environment, which is also overstimulating them. it is often that over-the-top sensory overload that has them developing apparent shutdown as a coping mechanism. difficult child 1 especially used to do this - he told me once after a session of deep studying that when he was concentrating hard he shut out all other input and that the silence in his head was so loud it became distracting.

    Did you ask this person's qualifications? Being someone's assistant doesn't mean she isn't a qualified psychologist. However, I agree, it does sound like some sort of psychological paramedical position. Which means - she shouldn't be diagnosing. Surely making a diagnosis is the prerogative of the high-powered professional you're paying to see your child?

    I'm curious - was this a private practice, or a hospital clinic? If the latter, they often cut corners and also train more people by employing less experienced people to sift through the heavy caseload. It gives them a faster processing time and boosts practice numbers.

    You wrote to us - have you also kept your own copy of what you wrote on your computer, in your diary of your son? I strongly recommend you do so. You included a lot of useful detail which I know you will forget eventually. Being able to read through this stuff can be very useful and can help shortcut later issues with docs as well.

    "Groovy."

    Marg
     
  10. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Marg, In my experience here in the States, University Hospitals are great!!!! I wouldn't, however, let anyone's assistant diagnose my child. I wouldn't even want a plain psycologist for a child who may have a form of autism. Our worst professionals, in my opinion, are the local low-cost mental health clinics. Since private practices here yield so much more money, my experiences with sliding scale, low cost clinics is that they get all the over-the-hill/worst psychiatrists and few specialists like Neuropsychs. We have had nothing but problems with professionals at our county mental health services. Our best experiences were with university hosptials. They are more on the cutting edge and do the research. Have a nice night (or day or whatever time it is Down Under :smile: )
     
  11. SunnyNC

    SunnyNC New Member

    HAHAHA Marg...I loved your reply.."groovy!" It is good at least I can chuckle about this I guess!

    This was a private practice that my peditrician's office actually referred me to. I will call them tomorrow and let them know of my experience. I did not ask for her qualifications...at first I didn't care as long as she could help us and offer the testing the neurologist wanted done. The next thing I knew, it felt as if we were all defending our positions and it probably would have just been fuel on the fire to ask what her qualifications were at that time! HAHA!!!

    You are right about the things we forget! I told my husband that I had gone to YouTube and was looking at videos people had made of their children with Autism because I wanted to know what it looked like...what it sounded like to look for subtlties that I may have missed over the years. I told my husband that some things were similar, but I noticed a common theme...the lining up of or stacking of items. I told my husband I don't remember difficult child ever doing anything like this. Well a light bulb went off for him and he said...YES HE DID!!! As husband listed the things he use to do, I DO now remember them!! He use to line up his matchbox cars in one huge row....he use to line up his stuffed animals on his bed every night before bed time...they all had to be in a certain order or he would get upset. Today he does not do that with animals, but his pillows have to be a certain way every night. It is very interesting how much of the little things that at the time seem so insignificant that we forget over the years. I will print off these messages I have typed..you never know when you will need it again for sure! Thank you for the idea!

    I do not know what the future holds for us...I am sure the testing (private practice) will shed some light at least to the path we must take to help difficult child lead a happier life. I will embrace whatever the answers are and do my best to learn all I can in order to help him be all he can be!

    Anyone who has been through the testing with your difficult child...what exactly is involved and how long does it take? I take it this isn't something that can be done in one day, but is this over days, weeks?

    I am not sure if I have reminded everyone how relieved I am to have found this list! :smile:

    Have a great day!!
    Rachel
     
  12. Marguerite

    Marguerite Active Member

    MWM, I didn't mean to disparage hospital procedures, it was more a comparison. There are advantages and disadvantages to each method. In our experience, our hospital clinics tend to be more overloaded and to deal with this, often hand out initial screening appointments to junior staff. The aim of this exercise is to give experience (which is always useful) and to also quickly sort through the enormous scope of the caseloads. It sounds like in this situation a private clinic is doing the same thing. The good things about this - it can cut through the cr*p fast, help you get answers faster than you have been. it provides early and intensive training to the right people. It can assess and assign patients more appropriately en mass.
    The disadvantages - sometimes these people are given too much leeway, too much credence and they make mistakes that can follow the patient for a long time. And even if the first consult with the health professional whose name is on the practice sorts out any misunderstandings, you still have the annoyance and frustration to deal with. Too often, though, the reason these interns (I'm using the term loosely here) HAVE the confidence to make these snap assessments is because their employer and supervisor doesn't challenge their initial assessment often enough. So be aware of this - you may have to work hard to set the record straight.

    Several things then come to mind here -

    1) The practice sounds like it could be overloaded, if initial consults are handled by a subordinate.

    2) You could also have a 'revolving door' practice here, where everybody comes out with the same diagnosis.

    3) Or this could work out well if the psychologist herself goes through the files thoroughly, takes on board the concerns of the neurologist and your recollections about his history, and isn't swayed by preconceptions. My main concern - if this is likely, then why would she farm you out to an intern?

    We went through a similar process with difficult child 3 while waiting for 'urgent speech pathology intervention". The first hoop we had to jump through, after an initial assessment to determine difficult child 3's receptive and expressive language status, was to attend a class for parents with kids who had a language delay. There were at least a dozen of us who had to meet on a weekly basis for ten weeks, two hour sessions. For the first half the kids were minded downstairs while we were lectured to about how to talk to our children. Then we spent the next hour playing with our kids according to rules we'd been given and while the therapists prowled around to make sure we did what we were told. To me it felt like fiddling while Rome burned - I knew difficult child 3 needed urgent therapy, I didn't need to be taught how to talk to him because I knew what was getting results and what wasn't. A lot of the things they told me to do clearly were a backward step for difficult child 3 but they made me do it anyway. To refuse would have had us kicked out of the program and we would have lost our chance at the eventual therapy.
    Because we spent so much time together I got to know the other mums (there were no dads in this lot) and I knew what the therapists were trying to do - they were trying to cut back on the number of clients needing/wanting therapy. Of the dozen kids, there would have been at least 8 who benefited sufficiently from this to be shunted elsewhere in the system.
    difficult child 3's autistic friend never got his therapy because his mother couldn't get herself to these sessions every week. She dropped out after three weeks, and so they dropped him even though he needed the therapy. She always played with him according to the rules they gave me - I remember how much stimulation this boy got - but she had no way to get to the clinic regularly.

    So hang in there, see how the next appointment goes and make your decision then. But in the meantime, can you book another appointment with someone else, on the assumption that this pediatric psychologist may not work out? Then when you know for sure either way, you can either cancel or keep the appointment with the new person.
    And when you make the appointment, make it clear that your husband wants to attend (as is his right - a lot of these clinics forget that) and if they are likely to be running late to please let you know so you can make arrangements. he is rearranging his schedule to fit in with the time they specified - they need to be accomodating also. You are clients, not supplicants.

    When we were trying to get difficult child 3 assessed I ended up making appointments with specialists all around Sydney (which is really saying something! This place is huge in area) and would cancel appointments if we got in to see an equivalent person sooner. I also asked each time to be put on a cancellation list, which meant a few times we had to rush because we'd get a phone call saying "Dr so-and-so has had a last minute cancellation - can you get here in two hours?" Sydney is three hours' drive across, but most of the time we could get there because we had a day's notice. And as happened with the pediatrician we settled with, he has other rooms closer to where we live so he's really quite convenient.

    Marg
     
  13. rejectedmom

    rejectedmom New Member

    UG! been there done that my daughter was diagnosis'd bi polar 2 by a psyciatrist. She didn't like the diagnosis and went to a SW and no has a diagnosis of Narccistic personality and ODD. Where does a scial worker find the nerve to throw out a psyciatrist's diagnosis? It boggels my mind the arrogance we run into when trying to help our kids.
     
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