frustrated with evaluations and child care issues

tryingtocope

New Member
I'm frustrated and very worried about what is going to happen this summer. Jan 2007- difficult child kicked out of preschool has been home since then. Mar 2007-took difficult child to psychiatrist who said he has ADHD and prescribed Adderall after just meeting him once. Apr 2007-took difficult child to developmental pediatrician and was told to get him evaluated by school district.

Last week I took difficult child to the second appointment with the developmental pediatrician. I was not able to get the teacher form filled out because he was fired because of some incident with a child. Developmental pediatrician told me she didn't have enough information to make a diagnosis without the teacher form and that I need to put him back in preschool. At this point, none of the preschools in my area are accepting children because the end of the year is quickly approaching. I only found one but it is a house that was turned into a daycare--not sure about their qualifications but will ask. I start my fellowship June 18 and have no one to take care of difficult child. All my local daycares have summer programs that start June 25 or July 2.

I also am terrified about how he will behave at a preschool. I found an integrated preschool, but it is only open 8:30-1:30. I thought that maybe if I found a nanny she could pick up my difficult child from the summer program and watch my easy child, but the cost is $500-600 a week. It would clear out my savings to pay this for 8 weeks (the length of my summer program).

Ughh...so my head is spinning. I have his evaluation next week, but I don't think it will be in enough time to get him services in the summer.

How long did it take most of you to get a diagnosis that you were comfortable with? How long did it take to get services?

Thanks.
 

SRL

Active Member
From the time I approached my pediatrician with my concerns to the time we were pointed in the right direction diagnosis-wise was about 3 months. It was another 3 months to get speech services through the district. In the next few years through research and further assessment we got a few more parts of the puzzle but the initial underlying diagnosis occured at the second visit with the developmental pediatrician.

I appreciate that developmental pediatrician isn't jumping to any conclusions but one teacher form shouldn't make or break it for a skilled diagnostician. Did he/she suggest any reasons for the behavioral issues you are seeing?

You definitely don't have enough time to get him services in summer if you haven't been through the initial meetings for qualifying yet. If you want any chance for services in place for fall you should have your request for evalution into the school district by now (in writing). Is that the evaluation that's happening next week? It's rare for them to grant summer services as the initial service offered, especially to a child who doesn't have a diagnosis. That may be changing now that schools are under more pressure to perform due to No Child Left Behind.

If you live in a university area, I'd check with the education department and see if there are any Special Education or early childhood majors who could do part time day care. If you can't find one sometimes splitting it up between two can work.
 

Sheila

Moderator
My signature reflects the evaluation timeline.

Re school: Finally, in 2nd grade we got a 504 (pretty worthless). It took until the last part of 5th grade to get his IEP. Hopefully, your situation will go more quickly and smoothly.
 

tryingtocope

New Member
At the first meeting with the developmental pediatrician she suggested that he may have a language processing issue. She didn't think he had a problem with attention. At the second meeting she said that since she did not have the form from the teacher he had in the fall and was currently not in school, she didn't have enough information to make a conclusion. She said that she would mail a report to me and his pediatrician within a month listing her concerns and observations.

Next week I have an evaluation scheduled through the school district. My next meeting with the developmental pediatrician is in July. She asked me to enroll him in preschool or a summer camp and gave me another teacher form.

I'm not sure, but the sense I got is that she doesn't see what I say I am experiencing. She even said that he has been given enough of a chance. It seems like she wants a teacher's observations before she comes to any conclusions.

Anyway, I am not sure what to expect of next weeks evaluation.
 

SRL

Active Member
Most of the time a diagnostician will come away with a first appointment with at least a general sense of what areas to narrow down the diagnostic search. The fact that after two appointments she still hasn't narrowed that down and is putting so much weight on one teacher's observations suggests that a couple of things could be going on.
1) As you mentioned, she's not seeing what you are experiencing. That's not at all unusual since most kids behave differently in a clinical setting BUT she should be taking your observations and concerns seriously. If you haven't already, go to our FAQ section and find the parent report. Work through that and see if there's any significant info that is missing. Make sure you have done your job in communicating the seriousness of the problem
2) Your child may have something neurological going on but is presenting atypically. We'll see this sometimes for instance with Autistic Spectrumy kids whose social skills are better than what would be expected. A good diagnostician should be able to deal with this scenario though. Likewise, sometimes we'll see kids who have symptoms coming in from multiple causes and it clouds the diagnostic picture
3) Sometimes kids will present with very difficult behaviors but fall short of any one diagnosis. In this case your doctor's report needs to be very clear and include recommendations because it's harder to get services for a child who lacks a diagnosis.
4) I hate to mention this possibility but keep it in mind. Sometimes we've seen doctors even at this level that don't take parents seriously for a variety of reasons. Once we had a mom come through here who was very young who couldn't get anyone to listen to her for that reason. She was articulate and knowledgable about children but her age kept getting in the way of getting anyone to take her seriously. Hopefully you have a doctor who is focusing on the child and not the parent but I mention it just in case.

Double check the forms you filled out at the developmental pediatrician. Do not authorize them to send a copy of the report directly to the school district. Get a copy sent to you, and if you agree then send a copy to the school district. This is especially important when the diagnosis isn't clear because how the report is worded could prevent getting needed help.

What to expect at the school evaluation: that can vary. The first meeting is to determine if testing is needed, and if so, what kind of testing. Then followup appointments are scheduled and those can vary considerably depending on the district. Some districts do a team evaluation where they meet with the child at home or at a school setting and do the full works on the same day. Others will schedule seperate appointments for the different specialty areas. Often for first evaluations screening tests are done as opposed to using actual diagnositic tools. If you really suspect an area such as language processing push for full scale diagnostic tools because those will yield a fuller and more acurate picture. Once the evaluations are completed you will meet again with the whole team to determine eligibility. If the child qualifies usually a seperate followup meeting is scheduled to formulate a game plan including placement, interventions, and goals.

That is how the process is supposed to look. Nowadays some schools are taking some short cuts to get children into services more quickly but there are some disadvantages to the quick route.
 
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