Got psychiatric evaluation back!!

[forkeeps251]

It's rather long (8 pages) so I certainly can't type all of it. The first part deals with my discussions, and then the observations of the psychologist, then his testing scores, and finally a summary, diagnosis, and evaluation.
The summary says the most, so here it is:

difficult child was referred for testing due to his significant aggression at school, poor frustration tolerance, trouble sitting still, social problems, and anxiety. The results of this assessment indicate that difficult child does have ADHD. Both his mother and teacher reported significant attention problems. The examiner observed how difficult child inattention and distractibility interfered with his performance on some tests. difficult child's est results also indicated difficulty with auditory attention, motor persistence, impulsivity, and adjusting his level of attention. difficult children inattention and distractibility may lead to him not paying close attention to what is going on around him. He may miss cues as to what behavior is appropriate and miperceive the behaviors of others. His impulsivity then contributes to his emotional reactions being exaggerated and explosive. difficult child also appears to have a significant level of anxiety, both in terms of social anxiety and general worry. He has nervous habits, seperation anxiety, and is overy self-conscious. His teacher and mother reported elevated symptoms of anxiety and his anxiety may also explain some of his miinterpretations and explosions. difficult children attention problems and anxiety combined with some other behaviors are also suggestinve of a possible autism spectrum disorder sugh as Aspergers. difficult children mode of play is generally repetitive and while he wants to interact with others he does not seem to know how. His over-sensitivity to noise is also commonly seen in children with Autism Spectrum Disorders (ASD). difficult children extreme difficulty with verbal skills and above average nonverbal cognitive skills is also common in children with Autism Spectrum Disorders (ASD). However, these symptoms can also appear independant of an Autism Spectrum Disorders (ASD) and may be explained by his language disorder and ADHD. At this time a diagnosis of ADHD and Anxiety Disorder not otherwise specified is made with a note to continue to monitor for Autism Spectrum Disorders (ASD) (also called Pervasive Developmental Disorders).


So, there it is.... what we've been waiting MONTHS to hear. I'm so glad this step is already done... although none of it really suprises me, to actually finally have a diagnosis feels good. Unfortunantly, his pediatrition is not "comfortable" (according to her office staff) persribing ADHD medication, so we have to wait for a psychiatric appointment. Fortunantly, even though it is typically a four month wait, I made the appointment back in December, so it is March 20th.

A few things I noted on the report were that he was very below average for verbal skills, but above average for nonverbal cognitive skills... I'm not sure what that means but it's nice all the same, because I have NEVER heard anything about him described as "above average".

There are three pages of recommendations, both for home and school. Including additional speech therapy, occupational therapy, social skills training, books, support groups, 504 plan, etc.

Granted I don't have a lot of experience in these things but it feels fairly thorough, with it being 8 pages long. I know they didn't test for EVERYTHING, pretty much just what our main concerns were (ADHD and anxiety).

The last recommendation is that if he still has problems after we follow the recommendations, to seek out an evaluation for Autism Spectrum Disorders (ASD).

So, thoughts and opinions?

 

[InsaneCdn]

difficult child's est results also indicated difficulty with auditory attention, motor persistence, impulsivity, and adjusting his level of attention

Has he had an Speech Language Pathologist (SLP) evaluation? If not, would psychiatric support a referral? If "auditory attention" is a problem, there may be APDs going on... especially in a noisy environment like a classroom.

Has he had an Occupational Therapist (OT) evaluation? "motor persistence" challenges... haven't heard that term before, but it almost suggests being able to "do" things some of the time, but not able to keep doing... can write a few words, but not a whole page, for example? If so... would psychiatric support referral for Occupational Therapist (OT) evaluation of motor skills?

Our evaluating psychiatric had to be pushed specifically on those points... but did end up supporting the referrals "if nothing else, to rule out any problems"... and... BINGO! (on both counts)

Neither of these evaluations would override a potential Pervasive Developmental Disorder (PDD)/Autism Spectrum Disorders (ASD)/Aspie diagnosis at all... often go in conjunction, OR can be "ADHD plus a raft of other things that don't quite add up to Pervasive Developmental Disorder (PDD)..."

Either way... there are interventions and accommodations that WORK for APDs, and for motor skills issues.

 

[buddy]

Well, since you asked, I would go for the Autism Spectrum Disorders (ASD) evaluation now... If there is a chance of this then you do not want to waste time getting intervention for it and holding him to the kind of interventions that work better for adhd. Early intervention is so important for Autism Spectrum Disorders (ASD) so knowing one way or the other, you wont have to look back some day and be bummed that you missed it. The report is right, those symptoms can just be a part of ADHD/anxiety. On the Other HAND ...many many have had kids called ADHD/Anxiety when it was actually Autism Spectrum Disorders (ASD) ... Given all of the other issues that do go along with Autism Spectrum Disorders (ASD), it is a big gamble to NOT check this out.

I'd also for sure go for the Occupational Therapist (OT) and Speech Language Pathologist (SLP) evaluation given this new information It will not only give you specific information but it can help support or deny the Autism Spectrum Disorders (ASD) issue as well as give you lots of help with underlying problems that might be there. SO Speech Language Pathologist (SLP) can help sort through the verbal/non verbal communication problems, help define specific issues and provide help. They can also help start to track any auditory processing problems including language processing. Occupational Therapist (OT) evaluation will help check some of the motor stuff and sensory stuff that was mentioned. These things can really be helped a lot with therapy no matter the bigger umbrella diagnosis.

If his adhd symptoms are really pure adhd, medications may be a great thing... Autism Spectrum Disorders (ASD) or no Autism Spectrum Disorders (ASD), processing and Occupational Therapist (OT) issues or no processing and Occupational Therapist (OT) issues. But medications may not be very successful if these other underlying challenges are causing him to appear very adhd. (certainly many of us have kids who genuinely have both concerns!) Only way to know if medications are going to help is to try them. Some people though do like to try some of the alternative therapies so that they dont have to expose their child to these types of medications. The occupational and speech/language therapies along with accommodations and a change in how we perceive our kids might be enough for some kids. In my son's case medication is a miracle. Not in that it cures him or stops everything but he would actually not be able to live in a typical home if not for medications.

So, you have confirmation there are some issues and that is WONDERFUL. (though I remember seeing it in black and white the first time made me cry too... just kind of took the last little bit of hope for a complete recovery out... but I still knew improvement was possible) I am sorry he said specifically a 504 plan... for sure ask for an IEP. (again my humble opinion) Your son sounds way to complicated to not actually have a written, planned and managed document with goals and objectives that can be followed over time. If things are OK for now, you might want to finish up your assessments.... then come in really armed for the IEP. If there is a child development clinic that focuses on autism, they often have psychs and/or neuropsychs who work with others who can do this evaluation. They have specialized testing that is even more precise than general neuropsychs often do so if you can find that, it is well worth it. Sorry I can't remember how he is doing in school... but if things are rough then put in writing your request for an evaluation for Special Education. services and send it certified mail.

SO glad you are moving forward. Your guy is little and you are getting him support already so that is just the best! What an awesome mom.

 

[lovelyboy]

This summary sounds very thorough.....It does make alot of sense....
I do agree....try the Occupational Therapist (OT) and ST assessments....whats going on with your son sounds alot like my son, but mine didnt meet criteria for ADHD....he ended up with Pervasive Developmental Disorder (PDD) not otherwise specified maybe Aspie......We also use some medications, for anxiety and Obsessive Compulsive Disorder (OCD), but I must say....the Occupational Therapist (OT) and ST impact is actually the main guns that is starting to help improve behaviour at the moment.....the Occupational Therapist (OT) is working hard on impulse control....your little one might be a bit to young, but the cognitive behavioural approuch does seem to start working now!
Glad that you are moving forwards!

 

[DDD]

So glad to read you got the N/P evaluation back. It's such a relief to "see" that the problems are not your imagination, lol, and to set a path for getting appropriate help. Most of us I'm sure got teary. Hugs DDD

 

[keista]

Ditto Buddy. IF there's a possibility of Autism Spectrum Disorders (ASD), get it checked out NOW. There is absolutely nothing to be gained by waiting and everything to gain by getting that diagnosis now if it is appropriate.

And by the way, with this report/recommendations, you'd be asking the school for a full IEP not a 504. 504 is just for accommodations, IEP also provides services which he's eligible for according to this report.