Was this guy even a neuropsychologist?

Discussion in 'General Parenting' started by BestICan, May 28, 2008.

  1. BestICan

    BestICan This community rocks.

    We finally got a referral for - let me make sure I say this right - a visit to a practice that says it does neuropsychologist testing. We did not get authorization for testing, just auth to have a consult so that the practice could request auth for testing. Insurance rejected testing from the reputable university pediatrician. neuro clinic, of which difficult child is a patient, because difficult child is not pre-surgical. Yucky, hideous insurance.

    Anyway, here's what I was expecting:
    A practice that performs a standard, comprehensive battery of tests that takes about 6 hours, which evaluates things like intelligence, mental health, neurological function and behavior. Possibly a team of more than one professionals.

    Here's what I got:
    A single psychologist who had a ton of IQ and other tests on hand, and offered QEEG testing and Neurotherapy (this is mostly in the form of computer games). I believe these fall in the category of "alternative." Not saying that's bad, but I wanted to point it out. He did *not* seem to have a specific repertoire of tests to recommend. He told me he knows my insurance company and they'll never approve a full testing workup, so he won't even request it. He offered to see us over the course of several visits and administer testing as we go.

    This visit concerned me. Something just seemed off when I asked about the full neuropsychologist battery of testing. His response was, "Oh, you want the whole Wexler test and all that...?" as if I was somehow going to get to pick tests from a menu. When I told him I wanted to rule out Asperber's and get a definitive diagnosis on ADHD from a professional who was examining my son while understanding his seizure disorder, he said, "Oh, I can give you an ADHD diagnosis right now."

    Yes, difficult child was exhibiting textbook ADHD behaviors throughout the visit. Problem is, both husband and I agreed that HE WASN'T BEHAVING LIKE HIMSELF! He was nervous and anxious and not comfortable there. It was like he regressed to his five-year-old self in that setting. (He's 8 now.) The phrase we often use to describe difficult child is that "he's like an onion - lots of layers." Anyone who tries to diagnose him in 30 minutes is not seeing the whole picture.

    husband is saying, "What's the problem? We'll get a 504, he'll have that in place for next year. Isn't that what you want?" My response is, "Sure...I guess..." Honestly? I do think my kid has ADHD, but dangitall, I want a reliable diagnosistic process and a full workup.

    So, is this the typical neuropsychologist experience? *IS* there a typical neuropsychologist experience? This practice does have a website. I won't make it publicly available, but if anyone wants to PM me, I'll give you the web address.

    Thanks!
     
  2. TerryJ2

    TerryJ2 Well-Known Member

    Hi, I tried to PM you but it won't work. Can you PM me with-the site?
    We've been to both types so I may be able to tell the diff.
     
  3. BestICan

    BestICan This community rocks.

    Whooops, I had to change some settings. Sorry, I can now receive PMs. I just sent you the URL, Terry.

    Thanks!
     
  4. Shari

    Shari IsItFridayYet?

    I don't think we've ever had a real neuropsyche evaluation, either, so I can't say, but I see your concern. I would be worried, too, about a guy who won't even try to get insurance approval, if for no other reason than to document the denial...raises my suspicions, too. Sorry I can't help more, tho.
     
  5. JJJ

    JJJ Active Member

    I wasn't too thrilled with our neuropsychologist either. The tests he did were all well and good and the results accurate but he didn't assess the main thing that we wanted looked at. He even noted that all results would be more accurate with full testing. Still not clear on why he didn't do full testing. But we had her transferred to a different hospital and when they read his report, they didn't get it either and they did all the missing tests.

    Combined the tests were:

    Million Adolescent Clinical Inventory
    Rorschach Inkblot Test
    Incomplete Sentence Test
    Projective Drawings
    Thematic Apperception Test
    Beck Youth Inventories
    Beery-Buktenica Developmental Test of Visual-Motor Integration
    Trauma Symptom Checklist for Children
    WISC-IV (IQ)
    WIAT-2nd ed(Achievement)
    Benton Visual Retention Test
    Aphasia Screening Test
    Wide Range Assessment of Memory and Learning-2nd ed

    Using all of the results, they were able to paint a pretty good picture of our daughter.
     
  6. klmno

    klmno Active Member

    Here is just my 2 cents based on our experience- it sounds like what you hoped for was an MDE based on your description of a team. Have you applied for an MDE at the Children's Hospital? You got a neuropsychologist. Ok, insurance typically won't cover the "complete" testing, so apparently he is defaulting to what he believes insurance will cover. In our case, I stated that I wanted complete testing (although I am ssure difficult child didn't get every test out there- he did get 6-8 hours worth). What my insurance didn't cover, I was billed for and paid privately, with my Mom's help. Even that portion was close to $1000.
     
  7. BestICan

    BestICan This community rocks.

    Klmno, so, "MDE" means multi-disciplinary evaluation? Yes, that sounds like what I wanted :) I didn't ask for it using those words, though, but I think it was refused anyway.
    As far as I understand, that would have been covered by the medical side of our health insurance, but they only cover that if the child is prepping for brain surgery.

    So we're basically left with whatever psychologists are available through our behavioral health plan. This fella appears to be the only one who offers neurospysch testing.
     
  8. klmno

    klmno Active Member

    Yes- now you are on the right track. Well, I'm not sure how this happened since I was desparate for a second opinion at the time (I guess for my own piece of mind). I applied with the child psychiatric department of a teaching hospital for an MDE. There is a lot of paperwork- release forms, history, etc., so it takes months. I didn't care how it got paid for at the time- I just sent the paperwork in. Finally, we had the MDE and I was never billed and never rec'd anything from the insurance company.

    Now, it would probably be useful to get what ever testing you can have done by this neuropsychologist. I don't know if MDE teams do it themselves or already expect it to be done- difficult child's had been done a year earlier and his questionable diagnosis's weren't so much tesst related. The test results have helped more with school issues. That will all depend on your difficult child's specific issues, but I don't think they are ever a waste of time.
     
  9. JJJ

    JJJ Active Member

    Klmno,

    What testing did the MDE cover?
     
  10. klmno

    klmno Active Member

    My son's MDE might have been atypical- I am not sure. The only test they did was a computerized test for ADHD. But, my son had already gone thru a battery of nueropsych testing 18 mos earlier, been in an acute psychiatric hospital, been arrested, and seen tdocs and psychiatrist for 18 mos. On the application it asked what exactly was I seeking. I was seeking #1 another opinion if this was unipolar depression, bipolar, or something else, and more importantly, #2 what was the recommended treatment plan. This was done at a mood disorders clinic at a teaching hospital, lead by a nationally recognized authority on mood disorders in children and adolescents (psychiatrist). By that point, we all were pretty convinced that it was a mood disorder at the root of it. The team also had an ed spec. (which I requested due to difficult child's issues at school at the time) and someone else- maybe a psychologist in training. I signed all realease forms from every place and person he had ever seen pertaining to mental and physical health. Their objective was to review all of that and discuss everything with difficult child and me, including what had been tried and worked or didn't work, family history, etc. I was prettyhappy with it.

    Now, I would have expected a different approach if we were starting at the beginning of difficult child's issues and didn't have some idea already of the underlying issues.
     
  11. susiestar

    susiestar Roll With It

    I don't have a lot of info on the neuropsychologist testing. My son was tested at the dev pediatrician's office. they had a whole team of professionals who tested him, then met and discussed what they each saw. It was a wonderful experience, and though I didn't know it, a neuropsychologist WAS part of the team.

    I can only say that if your instincts say this is wonky, follow them. ALWAYS follow your gut instincts. I am sorry if I misread and that isn't your concern, but that is part of what I read.

    Hugs,

    Susie

    ps. The only major mistakes I made with any of my kids are when I listened to an "expert" and not my gut instincts. The higher power gives us those for a reason!
     
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