? about 10 yr old with- anxiety

[jessfamilyof4]

Hi, I have a 10 yr old daughter with anixiety and Obsessive Compulsive Disorder (OCD). I want to have her evaluated but not sure who to go to. Her pediatrician reccommended child psychiatrist. Will they evaluate her thoroughly before medicating her? I am not against medications, I just want a thorough exam.

Her problems are much better now that she is older but we still have problems that need to be addressed. When she was younger she was much more aggressive, very defiant, extremely anxious!

Now that she is getting older she is still very anxious, somewhat aggressive but doesn't want others to see her aggression, Obsessive Compulsive Disorder (OCD) with locking doors (car, inside house etc) and sometimes seems depressed.

 

[InsaneCdn]

Hi, and welcome.
Sounds like a reasonably good family doctor... prepared to refer for more evaluations and such.

There are multiple types of evaluation, and unless you have a "team" doing the evaluation, it pays to build your own team.
Has she ever been evaluated by an Occupational Therapist (OT) for sensory and motor skills issues? Occupational Therapist (OT) has therapies that help, plus this report can be used by other evaluators including a psychiatrist.

Can you tell us more about her early years and early school years?
Family history? is she your bio daughter, or adopted? any history of dxes in the family?

 

[susiestar]

I agree that different types of evaluations need to be done. I have a son who struggled with aggression and depression and wish we had known about sensory issues when he was young. we have found that treating the sensory issues makes a really big difference, esp with anxiety and aggression. I recommend using a private Occupational Therapist (OT). Many of us here have found that they are more thorough and they do not have the added pressure of having to provide treatment out of a limited school budget if they find a problem. plus they evaluate how sensory and motor issues impact the entire life and not just the academic life of the person. School Occupational Therapist (OT)'s always mean well, but they do have less time to do the evaluation, pressure from administration to document only the most severe problems (schools must provide therapy if they document a problem), and they are supposed to only look at what impacts the child at school.

I know that there are school OTs who do the comprehensive evaluation, but generally parents find that private evaluations are more complete and more thorough.

For testing for learning disabilites and problems like anxiety and depression, we generally recommend neuropsychologists - psychologists with special extra training in testing and in how the brain impacts behavior and problems. they may run the same tests as toher psychologists, but they have a greater grasp of the way the brain works and it makes a real difference. they can often be found at childrens or university hospitals.

i think it is very very wise to want complete evaluations before you start medications. speech testing is also important (even if she speaks well) because it also uncovers auditory processing and language processing disorders, which can have a huge impact. others can tell you more about these.

welcome - this is a great place wth parents who have truly been there done that and won't judge and will be honest but understanding.

 

[BusynMember]

Take her to a neuropsychologist. By far, they are the best diagnosticians. How was her early development? Did she have any early delays? How are her social skills? Does she make good eye contact with you and strangers? Did she like to cuddle as a baby and any talking delays?

 

[jessfamilyof4]

As a very young child and even now she is not very cuddly and affectionate. She is a brilliant child! Learned many things very early, knew her phone # and address @ age 3, was tying her shoes at 3 etc. However sometimes seem "off" You can talk to her and she will say huh? That happens quite often. She is book smart on some things but has NO common sense what so ever! Its like she just doesn't get the simple things.. she reads into things way too much!


Has never been evaluated by a Occupational Therapist (OT), psychiatric etc... Talk to counselor back when she was much younger and she thought she was strictly Obsessive Compulsive Disorder (OCD), I said no she has anixiety and your mistaken. Now that she is older she is Obsessive Compulsive Disorder (OCD), locking the doors excessively etc.

She does have sensory issues. Very sensitive and extremely picky with clothes (the V necks- she won't wear them if the v is too far down, strange feeling textures bother her, picky about socks on toes etc)


She isn't a very socialable child. She is very defensive and feels they don't like her or don't want to play with her. Plays well with children a little younger than her. She acts like she is 35, things kids do annoy her. She says why are they doing that? I am thinking, cuz its a kid doing child like things! hahaha


Did I answer everything? Thanks to ya'll for your help & imput!!!

 

[soapbox]

I'm seeing two things in your posts...
1) Sensory issues. An Occupational Therapist (OT) evaluation isn't usually that hard to get, and provides good info. Easy to test for both sensory and motor skills - and even if you don't think there is a motor skills problem, there can be subtle things. Just pays to check the whole list and know what is a problem and what is not. The Occupational Therapist (OT) has therapies that help, and can also assist with accommodations and interventions at school and home...

2) The whole "huh" thing? Sometimes there, sometimes not? Could be several things, but one option isn't so well known: Auditory Processing Disorders (APD) - auditory processing disorder. When people are aware of this, they are more used to the classical "verbal language processing" issue - but there are several others. One of these is "auditory figure ground". People who have problems in this area, usually have normal hearing (or hearing correction is in place), and normal language processing. One-on-one, in a quiet enviroment, they do well. Add background noise, and the effort to follow and absorb what is being said can be more than the brain can handle or sustain... Classrooms are notorious for background noise; most of us filter it out without conscious effort. But even outside of school, many homes are also full of background noise... the TV, radio, computer games going in the background... on top of the water running for dishes/showers/laundry, the fan on the furnace, and so on. This really can be huge. And it can have social impact, if the child finds it hard to converse or follow the ebb and flow of peers, on the playground.

Auditory Processing Disorders (APD) testing usually begins with a Speech Language Pathologist (SLP) evaluation - specifically ask about auditory figure ground "and other APDs". If the screening turns up issues, an advanced audiologist who specializes in APDs would be involved in the diagnosis. This is not treated with medications, but with accomodations (written instruction to back up verbal, for example), and often with a sound-field system or personal FM system to increase the difference between the teacher's voice and the background noise.

 

[susiestar]

It was just recently that I even heard the term auditory figure ground, but it is a problem I have struggled with since childhood. it gets worse as I get older. It is also a cause of migraines - my brain cannot handle figuring out the difference between background, even music played softly si a problem, and someone speaking to me. I can't handle both.

Quite probably she has some degree of sensory integration disorder and this is a super hopeful diagnosis, in my opinion. One therapy has been PROVEN to change how tusually tell people that because they look at me funny. You MuST be taught hwo to do the therapy by an Occupational Therapist (OT) because you can cause huge problems if you do it improperly, but it takes very little time to do it properly, you just do it every few hours for several weeks/months, and then taper down as directed by the Occupational Therapist (OT). There are a lot of other therapies also.

We have books that help a lot of parents - frst is 'the explosive child, by ross greene - sorry my shift button is not working well. For sensory problems, the out of sync child by kranowitz is awesome and the out of sync child has fun is packed with activities to provide the sensory diet that can be super helpful. go with the activities your child likes - generally those are the ones they actually need - these can calm and soothe them and help hugely with activities. it did with all of mine, and with the kids in my odlest's sp ed class back in elem school.

again, sorry for the capitalization deficits. this keyboard is cranky and with a laptop it is hard to change it out.

 

[keista]

I saw everything soapbpox saw AND possible Autism Spectrum Disorders (ASD).

Sensory issues can stand alone, so can APDs, but those don't cause a child to be book smart with very little common sense, or cause them to act like a 35 year old thoroughly annoyed with normal kid things. High functioning Autism will do this, though. The Obsessive Compulsive Disorder (OCD) and anxiety round out the possibility of Autism Spectrum Disorders (ASD). They can stand alone as well. They can also be severe enough to be diagnosed in addition, but these are the most commonly identified "traits" in a person/child before Autism Spectrum Disorders (ASD) is properly diagnosed.

Disclaimer time. I'm not trying to diagnosis. I don't have any letters behind my name. I'm just a mom with some experience in the area pointing out what I see and what direction you may want to go looking in.

 

[BusynMember]

Count me in as one who is wondering about Aspergers Syndrome. These are normally very bright children who are quite prococious and often talk like "Little professors." They, however, tend to have no life skills/common sense and have very poor social skills with their same age peers. They are seen as eccentric.

I would take her to a neuropsychologist. Auditory problems, sensory issues, ADHD, the whole nine yards are a part of Autism Spectrum Disorders (ASD). And, by the way, so is Obsessive Compulsive Disorder (OCD) behavior, especially if she has obsessive interests. Does she have a very good memory by rote, like she can memorize a whole movie or a book? Does she tend to use phrases she hears on television? Does she have trouble with abstract thinking as opposed to concrete thoughts?

Many people think Bill Gates is an Aspie who has compensated for his problem, so being an Aspie does NOT mean you have to live a limited life. It really depends on your skills and if you are taught how to properly socialize! Many Aspies are known as being that eccentric but brilliant geek, not really that bad a thing

 

[Confused]

jessfamilyof4,
I agree with others to have her fully evaluated first. Ask her Dr or that Psyc Dr for referrals to the Occupational Therapist (OT) and Neuro. Keep documenting everything, Im sure you are already. Good luck

 

[buddy]

Hi and welcome and I agree, she really sounds like it would be worth going to a neuropsychologist and checking out the bigger picture. All of her symptoms can fall under 1 umbrella, and that is Autism Spectrum Disorders (ASD). May not be the case but knowing gives you MANY more options for therapy.