Tips for a Successful Evaluation

Discussion in 'Early Childhood Archives' started by SRL, Jan 2, 2006.

  1. SRL

    SRL Active Member

    Andrea, see if something like this would have been helpful for you to have had in advance. Anything that I've missed?

    Tips for a Successful Evaluation

    Before The Evaluation

    Evaluations are costly and time consuming so it's best to prepare for them in advance to make every minute count.

    -Do some preliminary research about the disorder(s) which have symptoms that seem to point in the direction of your child.

    -Don't make up your mind about a particular diagnosis in advance of an evaluation. Let the professionals do their job and give you their opinions. Most of us have found that it takes living with a diagnosis for a while to accept or reject it.

    -Write up a list of questions that you hope to cover in the evaluation and bring it along. Likely you won't get all of your questions answered on the first, second, or even third appointment but at least it's a starting place.

    -Copy all of the paperwork you fill out and bring it along to the evaluation. Also bring along copies of any reports that you've received from other professionals. A three-ring binder works well for this.

    -Do ask to be put on a cancellation list if your child's appointment is many months out. Let the receptionist know that you are very flexible and can come on short notice and be prepared to follow through.

    -Don't sign to authorize the specialist to send out the final report to schools, other doctors, etc. Review the report to make sure you're in agreement, and then send or hand deliver the report yourself.

    Making It Easier On The Child

    Taking a child who gets stressed by new places and faces to an evaluation is often a source of anxiety to most parents. Be assured that most kids come through the evaluation process well despite our fears, but there are some steps a parent can do to make the process easier on them.

    -You may want to avoid scheduling an appointment during a major disruption in a child's life, such as during a holiday.

    -Make sure that the child's routine is kept the days leading up to the evaluation, including getting plenty of sleep the night before.

    -Give the child only the information they need to know. Some will respond better when told in advance while others will experience less anxiety when given only small bits of information along the way. Stick to the facts (we're going to go to such and such place) and not the reasons (we're going to visit a lady who is going to test you for speech problems). Most children with communication problems won't be asking a lot of questions and don't need a lot of detailed information at this point.

    -Bring a second adult along to the appointment to look out for the child while the parent interacts with the specialist. The first appointment is often mostly parent interview.

    -Bring along snacks, a beverage, and books to occupy the child when the specialist isn't interacting with them.

    -Suggest a short break if you see your child struggling.

    -It doesn't hurt to have a HDB (Highly Desirable Bribe) prepared in advance. Evaluations are costly and important and sometimes a comment like "Just a little while longer and we can get lunch at McDonald's" or "You finish answering all of Miss Amy's questions and I'll let you pick out a Lego set on the way home."can be the right incentive to get a child over the final hurdle.

    During The Evaluation:

    -Expect for the time to go by very quickly with a lot of information being exchanged between the specialist and the parent. Bring a pad of paper and pen to jot down comments or questions.

    -If the appointment is with an MD, expect a nurse to take some basics (weight, height, blood pressure, etc.) at the beginning of each appointment.

    -Do be prepared for the diagnostician to discuss your child (including their struggles) with you while the child is in the room. This may be uncomfortable for you at first but most kids will be more interested in the toys the specialists usually keep in the room than boring grown-up talk.

    -If formal diagnostic tests are administered (ie speech, Occupational Therapist (OT), IQ, screening tools) ask for the specific names of those assessments and jot them down for future reference.

    -Know in advance that you will likely meet up with all kinds of temperament styles, some of which you will gel with better than others. If you encounter a specialist who wasn't what you hoped them to be, do your best to put in into context. For instance, it's important to have a good relationship with a therapist that will be working with your child on an ongoing basis. It's less important that a doctor who is doing a one time accurate diagnostic assessment perhaps with a few follow-up appointments.

    -It's not uncommon to feel defensive when specialists bring up your child's weaknesses or undesirable behaviors. It is necessary to factor these in obtaining an accurate diagnosis.

    -The specialist may or may not suggest a preliminary diagnosis at the end of the first appointment, depending on the amount of data gathered and whether additional diagnostic testing could sway the outcome.

    After The Evaluation

    -Expect that your child may be tired and possibly out-of-sorts after an assessment. Most diagnosticians who work primarily with children are very good with them but the process itself and deviation from normal routine can be stressful for many children. Keep the calendar clear for the rest of the day and night to give them some downtime to recover. Also, if you are traveling out of town bring along the child's pillow and blanket (and favorite comfort item for younger children) for the trip home.

    -Jot down anything you want to record about the appointment along with any questions for follow-up appointments.

    -Seek out the company of parents whose children are dealing with similar issues. The time between the first evaluation and receiving the final diagnosis and recommendations is often the hardest part of the process for parents. That's because by this point they usually are fairly sure that there is something different about their child but don't yet have a final diagnosis or prognosis.

    -If you are in the middle of the evaluation process, try and resist the temptation to spend hours and hours doing online research on one specific disorder. Something as simple as the outcome of an IQ test or a language assessment can tip the diagnosis in a totally new direction.
    Last edited: May 13, 2012
  2. pigless

    pigless New Member

    Take the time to create a parent report:

    I wish I had asked if Skip could leave the room toward the end of the evaluation. My pediatrician allows the parent a closed-door session after a check-up. I think the specialists should, too. It never occurred to me that Skip would sit there listening to everything.

    We had Skip looking forward to getting ice cream afterward; it helped.

    We also came across a lot of questions about the facility which is a Children's Hospital. Skip was alarmed by the ambulances and frightened by a child in the hallway who had totally lost it and the parent was not coping well. He's the type of kid who needs to be mentally prepared ahead of time.

    For example: when had tubes surgically implanted into his eardrums, I had taken the time to find out exactly what would occur. He handled a daunting situation better than many adults.

    As for his evaluation: I had prepared him through my friend, SRL's, advice and he handled that extremely well in spite of the obstacles I didn't anticipate.
  3. SRL

    SRL Active Member

    Thanks Pigless, this is the kind of feedback I need. LOL, I wrote this with Autism Spectrum Disorders (ASD) kids with strong reading skills in mind and most of them aren't alarmed by the ambulances--they're thrilled to get to read the words on the vehicles!

    Ditto with speaking in front of the doctor since those kids typically have speech language issues and miss a lot of verbal communication not to mention are frequently mentally engrossed in something interesting. Given Skip's age and temperament do you think it was a problem that he was listening into the conversation? Exactly what concern did you have with his hearing the interview? Did it just make you uncomfortable, was there some fallout later, were you concerned about self-esteem issues, other?

    I can add a point about requesting a closed door session but that would be dependent upon the parent bringing a second adult along to supervise or the office having a set up with a two-way observation mirror which I did encounter at one clinic but which unfortunately isn't the norm. These are unfamiliar clinical settings to children and they shouldn't be left in a room unsupervised.

  4. transformtriumph

    transformtriumph New Member

    I think it helps a great deal to know something about the disorders and possibly suggest certain areas for testing. Often, even a "complete" evaluation may not test for everything. With input about a child's communication abilities, social skills, etc, they will often include the appropriate tests.
  5. Andrea Danielle

    Andrea Danielle New Member

    Sorry, I haven't logged in for awhile, it has been a busy holiday...
    This looks great. Thanks for putting it together!
    One thing I would add is that if you are going to the specialist with your husband/significant other all of this should be discussed upfront and that both of you plan how to deal with your child's misbehaviour during the appointment. My husband is very involved with our difficult child and didn't want to miss a thing in the conversation and I am the same. As a result, there was this tension between him and I as to who should be dealing with difficult child, we both hoped the other would do it. A solution might have been to split up the hour in terms of child duty while the other was able to focus completely and then share notes after the appointment. Our difficult child gets particularly out of sorts when the attention is not focused on him and especially when he knows we are talking about him. He tried to interrupt our conversations constantly. It ended up being very frustrating. No amount of toys, books or treats would have taken him away from his goal of bugging us. One of us should have just taken him out into the waiting room and played with him.

    Thanks again for this!
  6. pigless

    pigless New Member

    SRL, Skip's a pretty savvy kid who has a tendency to use information to his advantage. I was concerned about fallout and self-esteem issues. It seems really to have worked more in my favor than I anticipated.

    He has an interesting concern for how adults other than his parents view his behavior. For example, one brief meeting with his teacher snapped his school behavior back in line. I don't believe he wants to return to the "special doctor" again.

    It certainly would have been more relaxing for me to voice my opinions to the doctor in private.