neuropsychologist stuff...

[confuzzled]

::

i cant figure out if i found a good neuropsychologist, or a complete nut.

difficult child 2 needs a complete workup, for functional status and educational reasons, and quite frankly, to rule in/rule out/make a damb decision on the alphabet labels, once and for all. because of the nature of the way things are going, HIS testing should be under the diagnostic umbrella, not the educational part. the school is doing that portion, and he will make reccomendations based on the results....(dont ask, its a weird situation)

during the psychiatric hospital stay they decided she was on the spectrum. fine. it seemed to explain a lot. maybe everything. except, of course, it didnt explain squat.

since then, its been determined she has a mood disorder. whether it stands alone or actually is a comorbidity, we dont yet know. neuropsychologist is convinced she Autism Spectrum Disorders (ASD)...yet this is the same guy who insisted the "polars" and the schitzo(affective)'s are SO rare and it couldnt be one of those.
and yet it was.

SO....
with each and every visit to this guy, he seems to be pushing me away from testing. i find it baffling, and kind of bizarre,in light of the situation. its seemingly a different excuse each time...first it was her age, and that most testing is geared to an adult, then it was "i'd rather see you spend your money on a therapist", and this week was the "well, you know it wont give info about the mood disorder, which of course i know, and am not looking for further diagnosis on the mood disorder from HIM, thats what she has a psychiatrist for. (and this was immediately AFTER he was perseverating on the Autism Spectrum Disorders (ASD) component--lol, i threw that in for giggles)....

at this point, he will only run the nepsy and the connors (cbt?, the computer one, not the stupid scales)....school will do the wisc and the woodcock. and i'm paying for it since those are both considered edu testing--which is FINE.

and now he's implying, for some reason, that what he will able to help me with is behavior mgmt, with maybe a few school modifications thrown in. he seemed to miss my point that now that she is on the road to stability from the mood disorder, that the behavior piece (which DOES seem to have been a symptom of the mood disorder, at least the major stuff) is probably the least of the concern...there are a whole host of edu issues that will need to be addressed beside behavior mod (he's big on rule charts--we are way passed that too). we know she has some processing delays, and we also know she scored ridiculously high on some of the subtests in the past...so my questions will center around specific accomodations and placements to combat some of the issues with school (like, even though i'm not supposed to know, she's "clustered", she has one kid in her class who literally makes noises all day long, she's in some spEd placement, which had been intended to compensate for giftedness that is backfiring badly--another weird situation, and so on...its pretty much a nightmare environment right now--and it needs to be fixed NOW). he also is seemingly either in awe, or terrified, of the amount of groundwork that i've already laid...she has an iep, related svcs, a para, a gifted afterschool program, etc--he keeps saying those are heavy duty services, and well, i guess so, but apparently they arent being utilized appropriately so they need major tweaking, based on some of the testings findings--i have no idea what some of the really specific things are that she might need.

not to mention, if all this is impacting her functioning, i need to know. meaning, i cant have 10 year old expectations if she's more on a 6 year old level, Know what I mean?? there has to be reasonable expectations for her--i cant set her up for failure if she cant function on an age appropriate level....

so....does anyone have ANY other suggestions?? are there ANY other specific neuropsychologist tests, or any other testing for that matter, i should be looking into?? i dont care what it costs, where she needs to go for it, etc....

or do i need to start over with a new dr? cause it took moving heaven and earth to find *this* on...if i go the major uni route i'm probably looking at a 1yr+ delay to just get an initial appointment

cause in all seriousness, this is a one shot deal. i'm seriously sick to death of discussing what ifs and maybes, etc. she's on the spectrum or she's not. she has adhd, or not. and so on. either diagnosis's will be firmed up, or they will be dropped (forever-this is IT). and symptoms will be treated accordingly...

because i'm so far past exhausted i cant even think straight anymore. i feel like i'm going in circles with this kid--for her entire life--and now we are at a major crossroad and i'm not sure which fork to take. i honestly need a psychiatrist myself at this point. i'm sick of life being so hard...like a few others here, i'm on year 17, with 10 more to go. it would be nice to be "just a mom" for once.

oh, did i mention i just got home fri from a overnighter at the regional hospital with difficult child 1 after a pretty good gi bleed?? and then we got 2 ft of snow...

 

[nvts]

Well, is there a developmental pediatrician in your neck of the woods? They can usually give you an answer if you're just wanting to know if she's on the spectrum or not. I don't know if they'll do anything as far as telling you where on the spectrum she is, but if you want an "is she or isn't she" faster than a neuropsychologist - that's the way I'd go.

http://www.medication.yale.edu/chldstdy/autism/asdiagnosis.html

Here's a link that may give you a better idea as to what would be tested during a neuropsychologist.

Good luck,
Beth

 

[DammitJanet]

Sounds like you have a wishy washy neuropsychologist doctor there.

I dont think you can dictate what testing is to be done...at least that was my experience but I think I had somewhat of a weirdo too. I wasnt at all pleased with my experience with neuropsychologist testing so I dont think they are the end all, be all of diagnosing things but what is, I dont know. I have no idea how you would get everything you want answered as far as the edu bit for school. I guess if you could go in with a list of concerns that you want answers for and have her tested for those areas and if he would listen and test for those things...well...maybe that would be good.

Maybe I can explain a bit better using myself as an example.

I have a prior diagnosis of bipolar and borderline that is not in dispute but this neuropsychologist decided that she just "didnt see any signs of borderline in me" even though she only knew me for the few short hours she was testing me and the 6 weeks I was hospitalized after having meningitis. During the time I was hospitalized I was so out of my mind, I was almost childlike. I was simply not my normal self! Of course, I didnt present with my normal diagnosis's!

She also wanted to label me with wanting to seek out medical conditions for myself because I researched what diagnosis's I did have and what medications I took. She told me I should stay off the internet and not look up so many things! Hogwash. I have never invented a medical condition. I beg them for less conditions!

She really ticked me off. Even my therapist who has been treating me for years tried to talk to her and came away with the same conclusion that she simply didnt like anyone who appeared to question her authority. If I asked her about what a test was for, she assumed I was going to beat it in some way. I was just asking to know. I think she had some form of paranoia going on herself. LOL.

 

[confuzzled]

thanks to both of you--

funny janet--thats kind of parallel to our situation. and thanks for posting it...it helps immensely to hear others experiences.

he first met her after the psychiatric hospital...she was in for a "break with reality" and was pretty manic--she was hardly herself to base much of anything on. and since she wasnt diagnosis'd with the mood disorder, much less treated for it, until, oh, two weeks ago, with 3 weeks of zoloft in her system and a disasterous trial of concerta--both of which ramped up some serious mania, i'm pretty convinced any opinions previously formed are so off base it isnt even funny.

but now that you mentioned your dr--it jogged my memory. he told me a story of another patient that went to a psychiatrist and was diagnosis'd with something (i forget specifically), but that *he* still is positive it was Autism Spectrum Disorders (ASD). i didnt think much of it at the time...now i'm wondering if its a particular interest of his.

and they actually DID ask me if there were any other tests i wanted to add...but, not for nothing, i'm not a neuropsychologist--how the heck should *i* know?! (and more to the point, wth am i paying HIM for?!)

i'm personally finding the same as you--this is not the be all end all, by far. maybe there IS no way to get all the info i'm looking for, but for crying out loud, at some point something needs to be done, not just discussed.

i could care less if they label her an avocado...all i want is treat whatever needs to be treated. even the Autism Spectrum Disorders (ASD) label...in our case, it literally changes nothing. she's not suddenly in need of ABA or discrete trial or any of those type of interventions. nor would that label suddenly qualify her for some kind of state services--she wouldnt remotely qualify as she'd be way too high functioning. (she could use a social skills group, but she also doesnt need a Autism Spectrum Disorders (ASD) label to get one...)

the only thing i'm in total agreement with is that a mood disorder needs to be treated, and treated with medications. we cant tease out the rest if we ignore that. fortunately, the abilify seems to be working for now...she seems reasonably stable.

everyone is hot on her having a therapist--well, again, fine. but of course the major issue is that the neuropsychologist and a therapist are treated as the same for ins. purposes, and i can only have one at a time. so even that is on hold until we finish up this stuff--which still now includes an interpretive session (she drew today), the testing, and the discussion of results...we are looking at well into march before we can even find a therapist. (thankfully she does see the school psychiatric, its better than nothing!)

and i'm also in the camp that if you keep looking under rocks, you'll eventually start finding snails...especially if your expertise is in mollusks.

 

[confuzzled]

thank you nvts...great link