Another neuropsychologist evaluation question

[wintak]

Hi all

Been awhile since I was here. difficult child has been on a waiting list for a neuropsychologist exam and is FINALLY going to have one BUT...I just don't know that I have a good feeling about this. Going through the childrens hospital pysch area. It is a teaching hospital and I was aware there would be an intern. I did talk to her about this and what she told me that she would never test more than 2-3 hours at a time so his evaluation has been strung out over 3 weeks (due to her schedule). OBVIOUSLY he can hold it together in front of a stranger for 2-3 hours at a time...

Anyway, I'm trying frantically to find out what a neuropsychologist exam IS. I am finding it's a bunch of different tests, which the administrator can pick (I've already told her no intellectual tests...already had that done a year ago...no learning issues) but it seems like, from what I'm reading, USUALLY it's done in one day. From those who have had this, is that true? Or is it also ok to drag this out over 3 weeks, 2-3 hours at a time?

He is 8 1/2 years old. We got through the summer but this year in school he's got a teacher who is not going to waiver on consequences (and I'm behind that all the way) so he might have a rude awakening.

Oh and he threatened to kill his sister last night in a restaurant over a balloon...and no one who heard him (including his sister) thinks he was just kidding.

Ugh

 

[BusynMember]

I think neuropsychologist evaluations are fine done in three hour increments, as long as you fill out all the forms you are given and he does the entire battery of tests. My son's first neuropsychologist evaluation was done in three hour increments. He still got a really good and helpful evaluation and this neuropsychologist was the first professional that seemed to "get" my son. I'm just curious. Your son was adopted, like mine. Did his birthmother abuse substances during her pregnancy? That can cause all sorts of disorders and behavioral issues.

by the way a neuropsychologist evaluation is both tests AND observation AND interpreting the child's responses to certain questions (or lack of response or inability to respond). My son had about ten hours of testing in all.

 

[wintak]

No known info about birthmother that is relevant. Unfortunately. That would really have helped us out.

Do I trust they'll do the right tests or do I inquire about which ones they're doing to make sure they're on the right track?

 

[keista]

Do I trust they'll do the right tests or do I inquire about which ones they're doing to make sure they're on the right track?

Do you have an idea what track they are supposed to be on? From my understanding of neuropsychologist, I'd just trust them. They should rule in and rule out a huge array of stuff.

I also wouldn't tell them no intellectual/educational tests. You might say don't bother with tests X, Y or Z, but if you have different ones, I'm more than open to them. That way you won't get any repeat tests, but also get tests that may reveal some new information.

 

[DDD]

The two neuro/psychiatric evaluations difficult child had were done in one day but not by one person. The team took turns with different tests given by different people. There is a very detailed parental information form that is required. That is where the psychs get background info as well as problems identified by the parent. You don't have to hope that he has a meltdown during the evaluation. I'm not sure that it matters whether it is done at one time or split over time. I am glad that you are getting the evaluation done and hope it benefits your family as much as ours. DDD

 

[BusynMember]

They should ask you behavioral info too.

 

[InsaneCdn]

Make sure you have a parent report (see site resources) or similar - so you have all the details of WHY you are there, in front of you. That way, when they ask questions, you don't have to rely on memory.
While you are in that process, also do a brief list of the reasons why you're there - for yourself, and as a summary of what you are trying to achieve. "We'd like to understand why he does X and why Y is so difficult for him and how to better handle conflict at school and... " whatever your list... the neuropsychologist (or any other comprehensive evaluator) will typically adjust which tests are administered, depending on symptoms and concerns - so make sure your list is detailed.

 

[Marguerite]

Let them do the tests that are standard on the table. The results from these and from other matters that get raised will determine the path of any further testing. It does sound like their testing will be detailed and comprehensive. It might not give you all the answers but it is a good step along the way.

Marg

 

[BusynMember]

Do you have any forms to fill out regarding behavior? We had, like, five of them...lol. They took a LONG TIME, but they really helped the neuropsychologist. We also gave a few forms to the school. That was a part of his neuropsychologist.

I'm not sure, but I don't think they all run the same tests. Some are more intensive than others. We wanted very intensive testing so we asked about the testing before son went. He has had two neuropsychologist evaluations. They were done by two different neuropsychs who never met each other and the last one did not even see each other one's report. They both drew the same conclusion: Autistic Spectrum Disorder. As his parents, we feel they did (both of them) very good jobs. I think you'll be pleased.

Two tests I would ask about are the TOVA (computer test for ADHD, which is way better than Connors) and ADOS (for autistic spectrum disorder).

 

[confuzzled]

i wouldnt rule out "intelligence tests" either--you arent looking for an IQ, but subscores that show strengths and weaknesses. they wont necessarily be the exact same tests run by the school district, and can help pinpoint things that arent technically Learning Disability (LD)'s.

i'd ask for the most comprehensive battery of tests they offer, and when its all said and done, i'd ask if further testing, such as an Occupational Therapist (OT) evaluation (fine motor), a Speech evaluation (pragmatics) and an audiological battery (processing) are necessary.

and yes, its not unheard of to spread the testing out over time--i cant say if its customary to do it over weeks/months, but i'm sure it happens. i wouldnt be overly concerned about that part, other from a PITA standpoint :-D

 

[seriously]

It is helpful to provide the information from previous testing for them. But I too would say you should not get specific about not doing particular tests or types of tests. Just because a particular test was done in the past by someone doesn't guarantee that it was done correctly or interpreted correctly. neuropsychologist's generally have a much higher level of skill and knowledge about administering and interpreting tests/assessments than, say, a school psychologist. and as others have said - it's partly about observation. The neuropsychologist observes how the child handles various aspects of different tests and this should in part guide the choice of assessments and the order in which they are done.

The neuropsychologist should have either interviewed you fairly extensively or had you complete forms along with a shorter interview to find out what the issues are and/or what questions need to be answered or explored. If this didn't happen then I would question the neuropsychologist's approach - how can they even know where to begin?

I think it's perfectly fine for you to ask the intern for specific information about their training, experience and who will be supervising them. Where are they in their training - just starting or all but dissertation - known as ABD? To what extent are they being supervised - professor sitting in on some of the testing? just reads the report? reviews results as the intern gets them done - this may be one reason for doing the testing in 2 - 3 hour stints. Do they have experience with kids with the same issues as yours?

 

[InsaneCdn]

Multi-appointment has the advantage of reducing testing being skewed by burnout.
Also allows for review of that day's testing before next appointment - results today may change tests run next time... + this because seeing X, - that because test Y rules it out...