RE: needing info on neuropsychiatrist.

Discussion in 'General Parenting' started by almostcrazy, Aug 1, 2007.

  1. almostcrazy

    almostcrazy New Member

    Hello Everyone, Marg, SmallWorld, MWM, DDD, Busywend, I am having a hard time finding a neropsychiastrist for my daughter. I have looked on the web on can find none anywhere around. I know there has to be one nearby, because I am close to Indianapolis, Louisville, and St. Louis. Does anyone have any recommendations?

    I got the results back from strep (no suprise) I was neagtive at this point, and we have to retest in 2 weeks. My daughter showed some signs of being her old self today, but I don't want Occupational Therapist (OT) get my hopes up. I am trying to keep an open mind, and research all areas. I agree that if you give the doctor the idea he will run with it. My daughter seems worse at night, especailly at bedtime. She really seems to come unglued at this point. She is still doing the same things, but they seemed less frequent earlier on today. I should have a psychiatrist narrowed by tomorrow, and I will start down that road. I would really rather start with a neuropsychologist at this point. She didn't seem to have the touching issues today, but still tells me everytime she touches, bumps, and says she doesn't know if she did it on purpose. I have tried to explain, but I still really think she is too confused to understand.

    My husband is really having a hard time with her rejection. He is a very quite person, and show feelings much. He also never can see the gray areas only the black or white. He also gives up were as I do not, and so he depends on me to find the answers.
    This is something that I can't get a quick fix on, and he has trouble understanding.
    My mother lives with us, I have taken care of her for most of my life. She is a very negative person, but she loves me unconditionally, and is trying to help. I don't have any extended family, so I don't have much help.

    Best to all
  2. smallworld

    smallworld Moderator

    This is just my opinion, but I would go ahead and see a child psychiatrist for an evaluation. And I would continue to look for a neuroPSYCHOLOGIST (NOT neuropsychiatrist) for testing. It can take a while to get in to see a neuropsychologist, and I personally think your daughter needs to see a child psychiatrist as soon as possible (unlike others on this board, we've had the most success with psychiatrists, supplemented by testing with neuropsychologists). I think you need both evaluations given the symptoms your daughter is displaying. Neuropsychologists are found at children's and university hospitals. Doesn't St. Louis have a large children's hospital? You might want to call there today.

    Good luck.
  3. busywend

    busywend Well-Known Member Staff Member

    Yes, call your local children's hospital and ask for a multidisciplinary evaluation.

    Explain to them the sudden change in behavior and you would like the medical work up as well as the neuro work up.

    You should get a team of doctors - here is the list:
    Usually, they include a psychiatrist, neurologist, neuropsychologist, speech pathologist, occupational therapist, developmental pediatrician, and an audiologist.

    Get your pediatrician on board just in case he has to call in a referral. Matter of fact call him first as he may know of a team such as this already.
  4. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    NeuroPsychs can be found at university and children's hospitals. I personally had better luck with a neuropsychologist than with two MDEs. The waiting lists can be long, but in my opinion they're worth it. A Psychiatrist will probably miss anything neurological, but you can give it a try.
  5. smallworld

    smallworld Moderator

    Neuropsychologists are very good for dxing ADHD, learning disabilities and Autistic Spectrum Disorders. They can also do psychological testing to get a "read" on anxiety, depression and other mood disorders. But they are actually not qualified to make a diagnosis of bipolar disorder, for example. Only a child psychiatrist is techniqually qualified to make this diagnosis. Furthermore, if a neuropsychologist suspects mood issues, he will absolutely refer to a child psychiatrist for treatment.
  6. Janna

    Janna New Member

    Honestly, I would just start with the psychiatrist. As long as it's a PSYCHIATRIST and not a PSYCHOLOGIST or therapist or counselor. An M.D. is what you're looking for.

    We did the neuropsycologist route, and truthfully, I wasn't very impressed. He totally did not see any of my son's Bipolar, which is so very clear. He did a whole gamut of testing, and came up with less than our psychiatrist.

    Obviously, every person gets different results from every doctor, but unless I was concerned over learning disabilities or couldn't get any answers from a psychiatrist, I wouldn't do the neuro route again.
  7. habibi

    habibi New Member

    You live near one of the top ten children's hospitals in the nation - Riley Hospital for Children in Indianapolis. Its part of the Indiana University Medical Center.
    For pediatric neuropsychology appointments call 317-278-2219.
    Let us know what happens.
  8. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    We actually saw both a psychiatrist and a neuropsychologist. Unfortunately, professionals are very specialized. Psychiatrists may spot what they feel is bipolar. A neuropsychologist can spot high functioning autism. They are unlikely to both catch the same things. The most intensive evaluation you can have is to see both. You don't know what's wrong with your kid, don't know if it is a psychiatric or neurological problem (or both). Unfortunately, because professionals are so specialized, things get missed. I'm totally shocked that psychiatrists missed the autistic traits in my son and misconstrued them as psychiatric issues. That's why it's best to see both and have them communicate with one another. That's, in my opinion, your best chance at the most accurate diagnosis. High functioning autism/Pervasive Developmental Disorder (PDD)-not otherwise specified/Aspergers can really mimic bipolar. Every childhood disorder resembles the other, which makes it even harder...Our Psychiatrist was qualified to diagnose bipolar disorder and he did diagnose it, but my son didn't have it. Thus he was on about ten medications he didn't need and had some scary reactions to them and gained fifty pounds. I'd cover all bases...if your son is on the Spectrum, he'll need interventions, not just medications (or perhaps not medications at all)...Lastly, in my opinion, you could get good interventions from the public school system. Is there a reason you are homeschooling? Good luck.
  9. busywend

    busywend Well-Known Member Staff Member

    The psychiatrist I saw for difficult child was too uninterested. He did not want to spend any time with her. Seemed like he just wanted to write a script and get to his next appointment.
  10. DDD

    DDD Well-Known Member

    Did you look up available child/adolescent psychiatrists that are
    on your insurance plan and within driving distance? If you have
    an outstanding childrens hospital they should be the key to the
    door. Habibi evidently is familiar with one with an excellent
    reputation. Exploring your insurance support is really important. Neuro/psychiatric evaluations are often expensive and not
    covered by insurance. The school board is required by Federal law to provide evaluations for children who have been identified
    as having special needs. Your husband would probably croak if you mentioned that right now. He would fear that your precious daughter would be "labeled for life". been there done that. Just want you to know that help can be accessed later.

    Remember you are exploring. No one doctor should be expected to
    be "the" one. It's kind of like may have to meet alot of frogs before you find a prince. Just make sure that
    even the frogs are well educated, trained and have fine reputations. The chance of "your Prince" being found in a large
    specializing hospital is a heck of a lot better than finding him
    in a local strip mall. on the other hand, Warrior Moms "hope for the best but
    prepare for the worst". Almost all of us have some type of story
    we could share that would make your jaw drop.

    You can do it. DDD (Keep making notes of everyone you speak to,
    every recommendation, every name and number. Someone who is not
    "right" in 2007...may be perfect 2010 OR may be perfect for some
    other Warrior Mom in the future.) Hugs. DDD
  11. almostcrazy

    almostcrazy New Member

    Hello Everyone,

    Yes, to most all of your questions. I have talked to the insurance company, searched all over the area, and checked a lot of the find a dr sites. I do have an appointment. on Aug 29th with a Child Psychiatrist. I will go from there, and see if he seems to know what he is talking about. I am still on the look for a neuropsychologist, because I do want to cover all the bases.

    I don't know how you guys cope. I have 1 child, and she at this point and drain me in a couple of hours. I have been watching my daughter at play, and she will use the words when she is playing with her toys, but not with us. She is constantly worring about these things she is doing being on purpose. I try to comfort and reassure as best I can, but it breaks my heart to not have the answers. She seems so distacted that she doen't let me finish mush of what I start anyways. She jumps from subject to subject, and sometimes I don't have any idea what she means. If I ask her she will only say she doesn't know. She seems to still listen if I ask her to do something, but things she knows she shouldn't be doing she is, and then saying she doesn't know if she did it on purpose. She very unoraganized, and loses things constantly. Simple tasks take her forever, and with a lot of reminders. These problems were apparent before, but not as bad as now. She really seems detached emtionally, and doesn't act as if she really cares about anything. Her room is a disaster, and if cleaned won't stay that way but a minute. She spends more time taking everything out, than actually playing. We were reading everynight, and noe she doesn't want to, and says she can't remember what I am reading to her.

    As far as Homeschooling it is something I always wanted to do with my child. I have made every attempt to keep her socializied with children of her own age as well as adults. I call it selective socailization. With the new problems that have come to light, I don't think redicule from peers will help her developmentally or emtionally. Children are some of the cruelest creatures on earth, especailly to someone different.

    Best to everyone. I'll keep you posted.
  12. DDD

    DDD Well-Known Member

    It would not be unusual for your Child Psychiatrist to know and
    recommend someone for testing. Like every other step in this
    process, there is a sense of continuity when professionals know
    one another and have a lengthly history of working together. on the other hand
    it surely isn't imperative. The goal is to find the best help available.

    You're doing great! DDD
  13. smallworld

    smallworld Moderator

    I agree with DDD -- you're doing great. One more tidbit: Call and leave a message with the child psychiatrist that if he gets a cancellation, you would be willing to be called on short notice to come in earlier.

    Sending positive thoughts your way.
  14. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    I did homeschool my kids for a year. I'm thinking that, after you get a sort of idea of what is going on (and I'd have the Psychiatrist speak with the neuropsychologist so they can compare notes), then perhaps you can get better interventions in school. My son may be the exception, but he has gotten wonderful interventions in school (I could have never given them to him--it's way beyond socialization, although his social skills have really improved too). Nobody ever teases my son. I hear that he is well liked, yet he used to be in a Spec. Ed class half the day. It's down to one period now. I think a lot depends on how the school handles the child.ALso, my son goes to a smaller school where everyone knows everybody else. I was also very afraid of ridicule, but so far it hasn't happened and son loves school. I'm lucky, because Lucas is a homebody. School is six hours where he's not home, and my particular son NEEDS that. Kids on the Spectrum tend to prefer sticking around the house and are real loners--(the sadder scenario is that some Autism Spectrum Disorders (ASD) kids WANT friends and have no idea how to make friends). That is also addressed in social skills classes at school. That has REALLY helped my son because he was socially clueless and needed text book teaching in social niceties. At least now he can pass as "normal" lol. But if you homeschool, I'm sure you can find the same resources they have at school too. You sound like you're going to cover every base, and I feel that's wise. We got nowhere until we explored different professional's view of our son. Frankly, all the Psychiatrist did was listen to us talk about son's behavior, and observe very "strange" He decided he had bipolar, pulled out the prescription pad and on Day One the kid was on Depakote, and the perscribing never ended. He's been off medications four years now. He's fine, never needed them. Psychiatrist still refuses to admit that son is not bipolar, even though he is pretty much mood stable. I have BiPolar (BP) and he ain't BiPolar (BP). You really have to challenge professionals if your kid isn't improving or if your gut tells you something ain't right. I do think you're a great mom. You are willing to do all you can to find the answer. (((Hugs)))
  15. SRL

    SRL Active Member

    Hi Almostcrazy,

    I'm the moderator on the Early Childhood forum and am just catching up now due to being out of town and my computer being down. This is a very trying time for moms when our kids behaviors worsen so I just want to encourage you that things can get better with love, patience, and proper diagnosis and treatment.

    I haven't had time to read all of the responses, but if this were my child I would be looking for the most thorough evaluation I could get. I would want a developmental and behavioral pediatrician or a pediatric neuropsychologist, in addition to a thorough speech/language workup as well as occupational therapy to explore possible sensory processing issues. This last area is one that doctors frequently bypass but can be huge in terms of how the child functions or doesn't function. Sensory issues frequently ebb and flow depending on how the child is doing emotionally so things that might have seemed like nonissues or little quirks can escalate suddenly into huge problems.

    Until you have firm answers, it would be best to treat her like an emotionally fragile child. Keep demands and expectations low, assume there might be reasons for her behaviors or quirks that you might not yet understand, and try not to take rejection personally. Put aside areas for now that you have been working on-training and teaching--you'll get back to those later. The more they see their behaviors impacting your attitudes and actions, the more the negatives can be fueled. You need to be steady and calm in your interactions with her even if she is shocking you.

    Good luck on finding the specialists you need. The last I checked there were developmental pediatricians on staff at several of the Children's Hospitals in Indiana so that might be a route to look into. Even if you do see a psychiatrist, please follow up with a specialist such as a developmental pediatrician or neuropsychologist because you will get a much more thorough evaluation that way most of the time.