Got psychiatric Report Today....

[DramaQueenLucy]

I got the report faxed to me today. I am having issues with some parts of this and think that there is more it then what the diagnosis is right now anyway.

The first thing is that is says "on the CBCL problem scales, total problems, internalizing and externalizing score are all above 90th percentile. Thought problems, attention problems and rule breaking syndromes were all in the 97th percentile."

The second "The results of the ADHDT revel that he exhibits above average. High levels of hyperactivity ad very high levels of inattention. In fact, his raw score for inattention was the hightest possible for that subscale."

The third "The results of the Beck Depression Inventory were not sufficiently elevated to warrant a diagnosis of major depression. However, he did endorse high levels of agitation, irritability and loss of energy"

The diagnosis
ADHD, predominantly Inattentive Type
Depressive Disorder, not otherwise specified
Auditory working memory disorder



So what do you all think? This was his first real evaluation, I don't understand all of it the ones that I just don't get I have put in italics. We are scheduled to go to the neuropsychologist on Oct 13th and again on the 31st. I am thinking that there is something more to this that the neuropsychologist will find. What is the next step up from ADHD?

 

[TerryJ2]

I can see why you are questioning the part in italics. I don't think it is worded clearly. I would call and ask for clarification.
Was he on medications when he tested? I would assume he would score higher on certain areas of functioning if he was.
I am debating whether to remove my difficult child from medications when he is tested.

I don't know that you can have a stair-step approach to ADHD. I personally (and this in only my opinion as a mom) think that many cases of ADHD (such as the level our kids exhibit) is a symptom of other things. It's like a clue that something else is wrong.
So your difficult child could have a mood disorder (chemical); Asperger's/Autism (neurological); allergies/disease, or any number of things that the testers did not want to label for whatever their reasons are.
I think the neuropsychologist testing may clear that up ... but it's typical that test results often raise more questions than they answer.

I love your tag line!

 

[smallworld]

What kind of health professional wrote this report?

 

[DramaQueenLucy]

No he wasn't on any medications when he was tested...I wanted a true result. The school however is pushing for medications asap I do see there point to some degree but since difficult child is going to the neuropysch doctor then why not wait until we get those results??

 

[DramaQueenLucy]

What kind of health professional wrote this report?

The Child Psychologist. I am not at all sure about the report. in my opinion, he didn't spend enough time with difficult child...he doctor himself said that further testing would be helpful.

 

[klmno]

Did he/she schedule an appointment with you to go over these results and answer your questions? I think it is the norm that they do have an appointment with the parents to go over things like that. Also, it's just my opinion, but with the results showing some indication of a mood disorder along with adhd (which I think sometimes is a symptom of other things), I'd try to get a consultation with a child psychiatrist who can review the test results and listen to the history and parents' observations- especially before starting medications.

 

[smallworld]

Here's a link to info on the Beck Depression Inventory:

http://en.wikipedia.org/wiki/Beck_Depression_Inventory

Basically, it's a questionnaire. The answers given determine whether various mood/behavior indicators fall into the category of Major Depressive Disorder or a somewhat lesser Depressive Disorder. Just so you know -- it's highly subjective and depends entirely on self-report.

I believe the others are questionnaires as well. I'll be able to research them later this evening.

 

[TerryJ2]

Thank you, Smallworld! That's a great explanation.
The Beck Depression Inventory is clearly based on self-assessment and cognitive skills, and does not take into account biochemical causes. (This simply means that the test is one of many tools, and it is useful, but not an end-all and be-all.)
This part is particularly useful to me:
The BDI suffers from the same problems as other self-report inventories, in that scores can be easily exaggerated or minimized by the person completing it. Like all questionnaires, the way the instrument is administered can have an effect on the final score. For instance, if a patient is asked to fill the form out in front of other people in a clinical environment, social expectations might elicit a different response compared to administration via a postal survey.[11]
Another serious limitation is that in participants with concomitant physical illness, it has been suggested that the BDI's reliance on physical symptoms such as fatigue might artificially inflate scores due to symptoms of the illness, rather than of depression.
Drama Queen Lucy, I hope this explanation helps a bit.
I'm also wondering if you have a followup scheduled.

 

[DramaQueenLucy]

No follow up with this doctor I plan on calling and asking for some specifis...but we went to difficult child#2's therapist today I gave her the report and she said that it looked to her like what it was saying in like the 90% was that there are only 10 kids out of a hundred that are worse then difficult child. It looks to me as if the doctor just used forms either filled out by myself, the teacher or him. This is no real exam to me...I think that I will wait until I get the results from the neuropsychologist evaluation before I medicate difficult child..we will just keep giving him a pop before school and if they listened to me they would be giving him 1 at lunch too.

Thanks for the information Smallwood & Terry...it has helped me make my decision!

 

[klmno]

Sorry, but I must have missed something- what exactly does this mean? A pop of what?

we will just keep giving him a pop before school and if they listened to me they would be giving him 1 at lunch too.

 

[witzend]

Lucy, I think it would be helpful for you to understand what the "scale" is, as in what is "within the range of normal scores"? If a child who does not test for ADHD in the CBCL problem test is 80, then 90 isn't so bad. On the other hand if that child would test at 20, then 90 is a real problem. CBCL is the "Child Behavior Checklist". I assume from the score, that the tester gave your difficult child a set of problems to deal with and looked for reactive behaviors. The question being does 90 mean he dealt well or horribly with the problems?

In fact, his raw score for inattention was the hightest possible for that subscale."

This just means that there were several factors included in the final score of this part of the test, including "inattention". You could look at it as a fraction 5/5 if there is inattention and four other parts considered. Inattention being 1/5 of the total score which is then averaged out. Like 4.0 being a perfect gpa even though you have 7 classes.

It sounds like the "Auditory working memory disorder" is a very good diagnosis, as it could be a factor in getting him help with an aid in an IEP. It means that he requires visual cues to remember what his task is. Hopefully that will be something they can work on. Also, the not otherwise specified on depression could be good. That means it could be situational and could get better with the right school/play environment. I imagine he probably feels like he doesn't fit in. That is enough to depress most anyone!

Good luck and keep talking to the therapist. Ask for information on what "the scale" is that they are working with.

 

[TerryJ2]

LOL. I want to know what a pop is, too. Popcycle? Sugar cube?

 

[susiestar]

Lucy means a soda with caffeine when seh says "a pop". However, IF a caffeinated drink is helping, then stimulants will probably help. and the help may last longer. I DO know that back in the 70s when my dad was teaching shop in ghetto schools (I mean no disrespect to anyone, but the schools were definitely ghetto) and had the ROUGHEST kids in the DISTRICT, he had several he gave coffee or cokes to. We had a VERY small budget, buy my dad still kept coffee on in his classroom and gave it to some of his kids. These were kids who's parents didn't always have FOOD, medication or doctor visits were not happening, period.

Several of these students had parents who came in to ask why the kid did better after my dad got hold of htem. He took no ****, truly cared, and had done some research. He advised parents to give kids coffee (for kids with ADHD type problems) to see if it helped and he gave the kids another cup of coffee when they were in his class, or if htey needed to, the kid could come to him during study hall or lunch.

It started some of these kids with a way tolearn and a way to get a better life, simply because they COULD figure out how to cope.

Lucy, can you send a pop to school with him in his lunch?

 

[klmno]

Ok, pardon my ignorance, but I thought sodas had a different mixture of stuff "back in the days" then they do now, not necessarily better, but different. And if he's thriving on soda, then crashing, doesn't that mean something? Is that too much different than self-medicating? It sounds like maybe he's being over-stimulated then he's falling, but for a short period of time in there, he's doing ok.

 

[DramaQueenLucy]

The CBCL is Achenbach but I can't seem to find the key for this test. I don't know about the other...I am calling the doctor tomorrow to see if it will then make more sense to me.

 

[DramaQueenLucy]

I don't really know if a soda helps or if it just helps him to sit and drink it to relax but either way it seems to help him relax...so I give him one in the morning before school.

Susie, sadly the BA school system outlawed pop last year.

 

[DramaQueenLucy]

On the report it say they used
1) Attention-Deficit/Hyperactivity Disorder Test
2) Beck Depression Inventory
3) Child Behavior Checklist-parents
4) Child Behavior Checklist-Teacher
5) Clinical Interviews

 

[dreamer]

Soda pop does seem to help lots of people with add and adhd type symptoms. Yes, becuz of the caffeine.....it is, IIRC milder than a RX stimulant.....but similar mechanism. If it works, go for it.
I am concerned about school pushing for medications. Not their place to input in such a way. in my opinion. They are not medication prof, and their job is not to request medications. This seriously bothers me when schools do this. Sorry, just me.

 

[witzend]

I'm not a big fan of all the stuff that goes along with the caffeine in soda pop. Any chance you could get him to take a caffeine pill? That way you know whether it is the caffeine, or the sugar, coloring, additives, etc. that is making the change.

husband was a 4 Mt. Dew a day guy. He also put on 45 pounds. He's a caffeine tablet guy now. He lost about 35 pounds.

 

[DramaQueenLucy]

The school is saying that difficult child 2 is behind and will continue to be behind until he can focus....well even in the report from the doctor it says that difficult child needs one on one as much as possible...but he only gets 30 minutes of this per day. They send a ton of work home that he didn't complete in class it is getting way frustrating!

difficult child 2...only gets 1 soda pop a day, nothing more unless he really starts to get extreme then I will make him sit down and drink another one. I will say that giving him pop every school day and using it the way that I do when he gets extreme, makes me feel like a bad Mother.
witzend, where would I find a caffeine pill?