pediatrician says diagnosis :V40.9 UNS MENTAL/BEHAVIORAL PROBLEM...

Discussion in 'General Parenting' started by Confused, Oct 29, 2014.

  1. Confused

    Confused Active Member

    for both kids. He thinks Anxiety still for daughter and showing some signs of Aspergers (but he cant say on the diagnose because she did get worse at her new school so he knows something is wrong but not sure. He mainly asked her about depression and friends, how her school work is, etc. Asked her a couple times each to make sure. And I asked him who and how shes going to be tested and I have a combined 21 pages of more info on possible diag and names to do an evaluation of.. he interrupted and said...

    neuropsychologist Evaluation !!!!!!!!!!!!!!!!!!!
    OMG!!!!!!!!!!!HE SAID IT!!!!!!!! YES I know caps are on dont mean to yell at you im doing a dance here and I hate dancing!!!!!!!!!! I froze and said" Thats it thats what I wanted for over 5 years with son and I want one for him AND daughter please!!! He said yes but never gave me the referral so I am going in the morning to see get it :/ I was gonna wait until I had the referral in my hand cuz I didnt want to jinx myself but you all have been my support for all these years and wanted to share.

    Thank you to ALL of you for not giving up .. I think Im getting closer!!!!!!!!! My kids will finally hopefully have some help!!!! Thank you is just not enough here!

    ****Oh Dr ALSO gave her some Hydroxyzine for Anxiety use ( basically allergy medication like Benadyrl I guess but hey.. who cares if it helps her)
     
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  2. Confused

    Confused Active Member

    :( I think I jinxed myself. Please someone tell me what is a neuropsychologist Evaluation ? Whats entailed? What did you or your children go through exactly? I know you all said it can last 8 hours. I cant find my old posts where you all told me the "type of Dr " that can preform this test.. please refresh my memory? Dr referred me to a lady who will diagnose adhd( her specialty) she is a Pediatrics and Behavioral Pediatrics MD but when I called them the person who answered said " she diagnoses, doesnt treat and the person who answered himself doesnt have a clue what a neuropsychologist Evaluation is. I told him daughter may have anxiety ( extreme) and or sensory processing and or asbergers...He assumes its talking to her and going over questions. They dont do EEG or Ekg nothing!!!!! The other one was a Occupational Therapist motor skills to help with therapy but I still need a diagnoses!!! Then he says Id need maybe a Psychiatrist for them esp my son since hes already been diagnosed with ADHD and sleep issues but needs further. Duh!!!!!


    I wish some of you can talk to these doctors here for me!!!!!!!! Below is what I found on the testing... But still confused maybe when my migraine goes away Ill understand it...

    What is a Neurological Exam?
    neurological examination may include the following:
    • The history: questions concerning your symptoms and condition
    • An evaluation of neurological function
    • Diagnostic tests
    • Electrodiagnostic tests
    • Blood tests
    • Other common tests
    Neuropsychological evaluation is an assessment of how one's brain functions, which indirectly yields information about the structural and functional integrity of your brain. The neuropsychological evaluation involves an interview and the administration of tests. The tests are typically pencil and paper type tests. Some tasks might beself-reportsmeaning that they are completed by the patient with assistance from a technician, but the majority of the tests require administration by a neuropsychologist or trained, skilled psychometrist. Neuropsychological tests (unlike bedside cognitive and behavioral neurologic screens) are standardized, meaning that they are given in the same manner to all patients and scored in a similar manner time after time. An individual's scores on tests are interpreted by comparing their score to that of healthy individuals of a similar demographic background (i.e., of similar age, education, gender, and/or ethnic background) and to expected levels of functioning. In this way, a neuropsychologist can determine whether one's performance on any given task represents a strength or weakness. Although individual scores are important, the neuropsychologist looks at all of the data from the evaluation to determine a pattern of cognitive strengths and weaknesses and, in turn, to understand more about how the brain is functioning.

    Neuropsychological tests evaluate functioning in a number of areas including: intelligence, executive functions (such as planning, abstraction, conceptualization), attention, memory, language, perception, sensorimotor functions, motivation, mood state and emotion, quality of life, and personality styles. The areas addressed in an individual's evaluation are determined by the referral question (what the referring doctor and patient wants to know), patient's complaints and symptoms, and observations made during interview and test administration.


    *****************I overall get the above info from two websistes BUT... these people didnt even know what I meant and Im so just uggh!!!!!
     
  3. InsaneCdn

    InsaneCdn Well-Known Member

    If you are not in the US... it's a different story. I'm not... we don't get "neuropsychologist evaluations" here at all. We can, however, get a comprehensive evaluation. Similar range of testing, similar time involved. Here, often done by PhD-level Psychologist with specialty in testing, or by a developmental/behavioural team out of a teaching (or children's) hospital.

    Occupational Therapist (OT)... you do NOT need a diagnosis to get good use out of. Occupational Therapist (OT) can do Occupational Therapist (OT)-related evaluations... sensory, motor skills, etc., plus provide related therapy and guidance. Don't wait for the other dxes to get the Occupational Therapist (OT) evaluation done - if you have it first, the other evaluators will take it into consideration.
     
  4. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Well, you didn't get a neuropsychologist. YOu got a pediatrician who decided she specializes in ADHD and will probably not know how to test for other things or even have the computer ADHD test.

    You can go to a neuropsychologist without a referal too. I did. The insurance still covered it.

    I don't think you'll get what you want from this pediatrian/behaviorist.
     
  5. Castle Queen

    Castle Queen Warrior in training

    A neurological exam is totally different from a neuropsychological exam. A neuropsychological exam (what you want/need) is performed by a neuropsychologist and in our experience didn't involve EEG's, EKG's or blood tests. What it did involve was a day of different psychological tests for my difficult child- memory tests, an IQ test, a test where he had to identify facial expressions, attention tests. While he did that I filled out questionairres related to Asperger's, ADHD, etc and there were some for his teachers to complete as well. I would assume the person you talked to just isn't very well informed because the dr. you were referred to sounds as if it might be the right "kind." Our neuropsychologist didn't treat either...
     
  6. Wiped Out

    Wiped Out Well-Known Member Staff Member

    Ours didn't involve any blood tests or EEG's or EKG's. It was basically what Castle Queen wrote. At the end of it we had a 17 page write up about his performance on the variety of tests and his findings based on his performance.
     
  7. SuZir

    SuZir Well-Known Member

    It really varies from place to place, some things are similar, some different.

    If I have understood it correctly in US neuropsychological evaluation doesn't include much of neurological testing (meaning EEGs etc.) When my difficult child was tested, it was more comprehensive evaluation. Really they didn't get it done in the day, first one was seven days and couple nights at hospital (if memory serves me correctly, it was long time ago) and even second one when difficult child was already close to a teen and they could work him harder, it was four days and one night. Neurologist, psychiatrist, psychologist, neuropsychologist, speech pathologist, special education person, physical therapist, occupational therapist and I likely even forgot someone making their own tests. Lots of papers to fill both for us parents but also school. All kind of things from sleep study to other neurological testing, cognitive tests, motor skills, attachment and family functioning, they videotaped his play on his own (with different type of toys), with an adult (both a psychologist and us parents) and with other kids and analysed that and really a lot of stuff from different angles. Case summaries we got home from it ended up rather massive even though difficult child never got any 'big' diagnosis and the outcome of latter one was summarized verbally by the neurologist with: "People are different, some are more so than others."

    It is so long ago, that I can't remember which parts were actually done by neuropsychologist. Most of cognitive testing etc. was done by psychologist anyway and actual neuropsychologist part wasn't much bigger than part of the occupational therapist or physical therapist. Of course one big difference here and in US is, that here neuropsychologist can't diagnose a squat, neither can of course psychologist. If you are not MD, you do not diagnose. Others just provide testing and info for the MD's to base their diagnoses to. In our hospital it was neurologist who was head of the team and made the diagnosis, in some other hospitals the same teams are headed by psychiatrists and they do the official diagnosing. Of course doesn't make much difference though.
     
  8. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    What Castle Queen and Wiped Out said. That was it exactly.
     
  9. dstc_99

    dstc_99 Well-Known Member

    The problem you most often have is that your pediatrician or regular doctor doesn't really know who does neuro psychiatric evaluations. They know that when they have kids who need stuff like it they send them to Dr x and that usually works.

    It is hard to get them to understand that you need to see something more specialized than a normal therapist or podc. My suggestion is to call around to the local big hospitals or teaching hospitals and see if they have someone who offers them. You can also google it and then contact the nearest doctors and then quiz them on what they do before making the appointment. I also used my insurance provider and had them give me a list. It was still frustrating because the insurance didn't seem to have a clue what a neuropsychologist evaluation was and kept giving me docs who didn't do it.

    Finally got an appointment and difficult child ran away to the grands.
     
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  10. Confused

    Confused Active Member

    Thanks everyone, yes In the U.S and no I dont think the doctors know what they are doing or whats needed. I found someone in another state but a short drive away who specifically says" only does neuropsychological evaluations" !!! But I don't know if he will accept our insc of course I will have co pay Im sure. But hopefully in payments! Ill find out in the morning. If not, thats a lot of money! I saw one dr charging almost $5,000 plus additional tests if needed! Hopefully if he accepts us, the waiting period isnt to far off, both kids need it but right now my daughter first for this school.
     
  11. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Confused...psychiatry is a very iffy field. That's what I like neuropsychs. To the best of their ability, they spend hours testing and observing and they do give you and the child's teachers many forms to fill out, not just the one Connor's Test (thanks for reminding me, Castle Queen, about all the forms).

    Confused, if you contact a university hospital, they take Medicaid and are probably the best, most forward thinking places to go for diagnosis. If you don't have Medicaid, then I don't know. I hope you do. Medicaid covered our entire testing. Beware of a short waiting list. I know...it's screwy :) But most neuropyshs that are worth their weight are booking far out because this is the best way we have to diagnose in the U.S. Your kids already saw a neurologist. It is not the same thing./ A neuropsychologist is a psychologist with special additional training in the brain. They know how to test, even test on a computer test for ADHD. My daughter Jumper failed that one big time so we knew we were dealing with at least ADD or ADHD. I passed it so I knew my spaciness was not due to ADD or ADHD (yes, I had one too).

    For every test we had, there was an intensive three to four page explanation of t he results plus that coveted diagnosis, Axis I, 2 and 3, which almost guarantees school services and community help. Recommendations are made. This is how Sonic easily slid into getting adult help and SSI, job help, and a caseworker who is very helpful too. The evaluation can be gold for future years if it turns out th at your dear children may need a little extra help transitioning to adulthood.

    A pediatric behaviorist/ADHD specialist is not going to pull as much weight. And ADHD alone does not usually offer much help, at least it is normally (not always) considered a mild problem in the U.S. I say in the U.S. because you live HERE and have to deal with OUR system with all it's flaws as well as t he good parts.

    Hugs a nd I hope you can find a way to get neuropsychs covered!!!!!!
     
  12. Confused

    Confused Active Member

    Thank you, your right, its iffy.I have insc from their father and medicaid and the place out of town WILl do the testing for both kids! Insc covers most of the bill for both, so I will have a copay due at service and maybe a bill later. ( out of town wont except my medicaid) The office says they are the exact testing what my kids need, he diagnoses and is board certified. I wont need to go all around town to people not being able to understand or not do the proper tests. So, fingers crossed until after their appts and diagnose1! Yes both! Oh pediatrician wants me to stick with someone here in town but everytime I go to them ( except sons neurologist) I got the run a round. I think I should stick with this guy

    Glad your kids got tested and treated and doing better now. Hope everything works out for you as well :)

    Its crazy here with everyone's opinions or hating on me, no one has walked in my shoes until they do they dont understand. You all understand , I understand but we may not understand every detail. I just want my kids to get help, me work and not be treated as if Im the worst person in the world. I used to be god at things! Confidence is gone. Between family and life it drains ya.

    ***Oh daughter is officially pulled out of school and praying her tests this week at other gets her in if they see she has an issue. She started her anxiety medication.. oo need to update my sig now...
    Thanks all I hope finally I have accomplished something for my kids. When I can Ill read again hugs to all
     
  13. confuzzled

    confuzzled Member

    I have insc from their father and medicaid and the place out of town WILl do the testing for both kids! Insc covers most of the bill for both, so I will have a copay due at service and maybe a bill later

    I highly, highly recommend working very closely with both the doctors billing people and your insurance company before doing anything. I absolutely recommend you get pre-authorization from the insurance even if you technically don't need it.

    some companies will pay for certain testing regarding what they deem *medical* diagnosis, but balk at what they consider *educational* testing...which, since they are kids, a portion of it will be.

    you don't want any gigantic surprises X2 and it seems to me that a large bill at the end would be stressful. dot your i's and cross your t's to make sure you know exactly what you are getting into and exactly what it will cost.

    in the off chance this becomes cost prohibitive to do privately, i'd have a backup plan and call your Medicaid office and ask them for a few providers and go with someone they recommend so you wont have huge charges. they often have very long waiting lists if they are Medicaid providers.

    good luck. just be crystal clear on what is and is not paid for, along with the full scope of tests they plan to offer (and they may not know as of right now until the initial consult)....no point in doing this if its limited or incorrect testing.
     
  14. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Confused, if anybody hates on you, you come here and we will remind you that THEY DO NOT GET IT! You do not deserve that; none of us do. That's just garbage.

    I'm glad you have testing ready and hope for the best and I know you are trying as hard as you can.
     
  15. Confused

    Confused Active Member

    Thank you confuzzled- Yes, she ran it and how much they pay- they pay 90% so not bad. They are set for their appts! Good points tho, I will call and double check.

    MidwestMom- Awww thanks!!! Well after all these years its happening but I wish sooner.

    ******I found out today my son is bullying a younger girl. So Im going in the morning and speak with the Principal and teacher and have my son there. I was just saying how proud I was he was holding in his anger at school. Im going to look up old threads from everyone here and see the advice you all gave to them, I dont want him kicked out. He has to stop this I dont wont him turning out to be an abuser or murderer- Im getting scared.I talked to him but I dont know how I should punish him, what punishment is best for this? Hes taking no blame and denies it. I know he needs anger management classes Im researching this for my area as well as telling his Dr.s. Also on Halloween my friend told me her daughter handled a boy that was bullying him ( boy in older grade) I asked my son how he felt about that and why would he do this to someone else. He said she started it by hitting him with a ball. I doubt she meant it. He takes things the wrong way many times.
     
  16. Confused

    Confused Active Member

    Well, I am going to show up at his school off and on as well as sending other people to "pop in" . Hes already bad this morning names throwing things because I didnt put his fountain drink with 2 sips or so left in the fridge last night. So he purposely over pours another drink to wear it overflows, and says he doesnt care if my blind and disabled grandpa slips on it with him right behind my son. Threats of k&**, refuses his medications. My friend who I texted in confidence let her mom read all my tests to her! Im so hurt and betrayed. I mean yes, her mom lived through this with my friends daughter but I didnt want or need her to know every aspect of my life. Here, Im anonymous so its ok, I feel safe to a point but some threads Id like gone cuz it does pin point me and also hurts me to read it as well as if my daughter ever saw this.

    So she says take him off Daytrana patch and admit him in hospital couple months. Well if he took his clonidine he'd be better I think? Off his medications hes just worse. I don't know its always circles and things just hit the fan with grandpa. So daughter got some testing done for admittance to this school and tester is recommending her and sees Aspergers. Im told shes looked "depressed" as others call her since kinder/1st grade and told this to the tester- she agrees shes not but we are still checking to make sure. But shes not depressed..yes Dr went over her plus further testing is coming up for that evaluation.

    I want to read other questions but I am just not at a place to do so yet again.. But, I am keeping you all and the new comers in my thoughts. Hugs
     
  17. Wiped Out

    Wiped Out Well-Known Member Staff Member

    I'm sorry things are so rough right now. I don't know if taking him off his clonidine would be any better, maybe? I know at what point when my difficult child was in the hospital they were going to take him off his clonidine because it wouldn't be compatible with a new medication they wanted to try. Withing 6 hours they put him back on his clonidine because on one could handle him in the hospital off of his clonidine.

    I am praying and hoping something changes for the better. A couple of months is a long time to wait to be hospitalized if he needs is now. (((hugs)))
     
  18. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Confused, thank you for keeping us updated. You've been fighting a long time and we care.

    Honestly, some Aspies (not all but many) just don't show any facial emotion and that can easily be mistaken for depression. It doesn't mean they are actually depressed though. You are hanging in there well and doing a good job. We are here for you.
     
  19. GuideMe

    GuideMe Active Member

    I feel the same way, but I came to a point where I don't care anymore, but I still do everything that I can to protect myself. However, I highly doubt anyone you know would ever read this and identify you. It's a one in a million chance. You have a better chance at hitting the lottery.

    At home, make sure you only sign onto this website on your own computer and always sign out. My lap top has a password (like all easy child's') and I never give anyone my password. No one , not even my close friends or family are allowed to use my computer, not even to look up a phone number. My computer is like my diary and I protect it as much as i can. So long as you do this, your children won't see it either. If in the one and a million chance someone identify's you, well, they found you because they are going through the same thing! Just keep in mind how much your story helps others. If it wasn't for reading thousands of stories online for a lot of the things I go through, not just from difficult child, then I would have been dead now from suicide. It helps so much not to feel all alone. Some peoples stories have helped me through so much and they never even know it.
     
  20. Aimless

    Aimless New Member

    Hi,
    Our neurologist recommended that we take our then 8 yr old difficult child son to a neuropsychologist. BEST thing we ever did!!!

    Neuropsychologist basically are solely interested in how the brain works, or doesn't, and how it manifests in the person's life. They do not do talk therapy and were not covered by our medical insurance but we opted to eat ramen noodles for a summer and go ahead with seeing the neuoropsych dr. First, the Dr. met with us to take a very, and I mean very, thorough medical, mental, social, emotional history of our difficult child. He asked the kind of really insightful, logical, and obvious questions that assured us that we finally in front of the right professional!

    Then he talked a bit about how our info about our observations and experiences with our son are likely caused by executive function deficiencies and recommended the array of tests that would help to quantitatively measure just how our difficult child was in fact functioning. The then, with our approval, planned out a schedule to meet with and test our difficult child using a battery of testing tools that addressed the areas we saw as concerning. This will differ by child. Then he met with our difficult child about 8 times for 1-2 hours to perform tests. He then compiled a super resourceful report of the test findings that we have found very useful in sharing our difficult child's needs with schools and teachers. Our son was tested for speech language development, object/naming abilities, short term, long term, and working memory, visual and spatial abilities, rigidity, social skills, IQ, problem solving, coping skills, and more. We discovered that while he was anxious, he did not have ADHD, which surprised us and his teachers. We also discovered that his working memory was very limited while his long term memory was very advanced. We learned that his weakness in the executive functions of concept of time, planning, initiation, organization, and persistence were grossly under developed and were the likely cause of the avoidant, passive aggressive oppositional manner in which he met the world at large.

    The whole neuropsychologist evaluation and treatment plan cost us roughly $5000 and about 9 months but it was well worth it. We are not wealthy folks and with 8 kids we needed answers and solutions fast because our difficult child's extreme behaviors and family interactions were escalating rapidly. Now he is 10.5 yrs old and still struggling with most of the same issues. The difference is that now we have a much better understanding of his capabilities and challenges. While it does not make enduring his odd, negative, cold and needy manner of interacting with our family any more enjoyable, at least we understand why he perceives the world this way. We are feeling a lot more confident about holding our boundaries, improving our timing, using rewards and consequences, and communicating with my husband and school staff about difficult child's need for structure, accountability, as well as compassion and grace, when appropriate.

    I will be hoping and praying that you find a neuropsychologist in your area and that it is an affordable option. Blessings to you and your family. I hope that sharing our experience is encouraging to you. :)
     
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