neuropsychologist said he's not an aspie

TerryJ2

Well-Known Member
What an interesting appointment.

We went to the neuropsychologist Fri. It took place at a satellite facility connected with-a very lge, well-known children's hospital. I had filled out several surveys, as had difficult child's teacher, and incl. the psychiatric-social testing we'd had done 2 yrs ago.

The dr. was very focused, very interesting.

Short version: he said difficult child is not an aspie.

Long version:
It was a "regular" appointment in re: to blood pressure, ht, wt, etc. Then the dr came in and asked difficult child a slew of questions.

The first Q was a "normal" statement. "So, tell me about yourself."
difficult child shrugs his shoulders, looks around the rm... this goes on until I can't stand it and I say, "What school do you go to?"
Dr. puts up his hand and says, "No prompting, Mom."

difficult child finally started to talk. It was like pulling teeth. But one reason I agree with-the neuro psychiatric in re: to difficult child not being an aspie is that I know when you ask an aspie why someone is their friend, they'll typically say something like, "Because he carries my books."
difficult child said, "My friends are nice. We play baseball and video games. And we all hate to sing."

My eyebrows shot up when he said that. It was so obviously not an aspie answer.

(by the way, I know a 17-yr-old aspie who will give a "normal, social" answer to that Q but he's been coached and trained for yrs and he has come a long way. He's got the accent and the clumsiness, too.)

After he finished "interviewing" difficult child, the dr had difficult child leave the rm and then he asked me to concur--or not--with-the answers. Most everything difficult child said was very accurate. It was funny because the questions were just regular questions to an untrained observer. But in this situation, I could see the dr. watching difficult child's facial expressions, eye contact, pauses, hand movements, etc. and how the dr had to prod difficult child to use long sentences. At one point, during a "regular" physical exam of the neck, shoulders, lymphs, stomach, etc, the dr asked difficult child "If you could have any 3 wishes in the whole world, what would you want?"
difficult child said, "Nothing."
WHAT?
difficult child has always showed a lack of imagination combined with-inhibition and shyness in an unfamiliar situation. He will more willingly choose from concrete activities or items set in front of him.

"Nonspecific" is the word that the neuropsychologist repeated several times.
I kind of feel like I'm back at square 1. But he did rule out Asperger's so at least that's one step.

He also said that Concerta now comes in a skin patch and that would eliminate the pill swallowing problem we've been dealing with. Problem is, even though it's related to Adderal, it's not identical and I'm hesitant to experiment when Adderal works so unbelievably well.

The dr. told me he thinks difficult child's behavior at this point is all ADHD, with-ODD, with-developmental delays. The lack of eye contact he said is difficult child looking at everything around the room, rather than looking away that Aspies do.
difficult child craves a high level of stimulation (despite the fact it makes him crazy).
Uh, yeah. :crazy:

The dr asked about hysterical laughing etc. and depression and anger (implying we may be seeing the beginning of bipolar). He asked a lot about whether difficult child's bparents used drugs. I wrote in the history that the bfather did use drugs (pot, at least) and the dr. hypothesized that it may be a response to his own ADHD.

Yes, difficult child does laugh hysterically and inappropriately. Just recently, in the past yr, he has learned to chuckle at not-so-funny jokes and sarcastic remarks.
That may be part of his slow development and we just have to keep working at it. Sigh.
The dr referred us for language and speech devel. testing.
We will meet this neuropsychologist again after we have those tests done.
He said to continue seeing the child psychiatric to work on behavior modification and on the anger and transitioning issues.

I really wanted to sit there for a cpl hrs and pick this guy's brains. I've read so much, but to have someone there in front of you who can read between the lines and explain the subtle differences between the behaviors is very cool.

As usual, I always want more info. But at least we took this step and I understand where he was coming from.

by the way, I deliberately did not give difficult child his pill that day. It's easier for the dr to see the "real" kid if his behavior isn't masked by medications.
We stopped at KFC on the way to the appointment and were in a rush. I had very little cash, so deliberately chose that because they take credit cards. difficult child wanted popcorn chicken (which is fried in wheat flour) and I thought, heck, let's load him up and have him really put on a show for the dr! :smile: But after waiting in line for 15 min, we were finally told the credit card machine was down.
We left with-no food.
difficult child was ready for a meltdown. Uh oh.
But I didn't engage him. I agreed with-him... except for his phrasing. "It's all your fault! You lied!"
I said, "I can't believe they made us wait in line and we didn't get any food. You poor thing. You're a good kid and you're hungry. I am really mad at them. I am never shopping there again. Maybe we can drop off the paperwork and then pick up something to eat if they make us wait a long time at the dr's ofc."
Once we got there, it was very efficient and we zoomed through everything. difficult child kept prodding me and saying I lied and he was hungry. I ignored it.

No explosion.

(Yes, I was aggravated and stressed out but I didn't rise to the bait.)

We stopped by McDonald's on the way home and I bought him wheat-covered chicken nuggets, only after getting him to promise he would run, run, run around outside.
He was not pleasant but he didn't explode, either.

I am so proud of both of us.
 

smallworld

Moderator
Did this neuropsychologist do any testing with difficult child, as in IQ, achievement, motor, psychological, executive function, etc? A true neuropsychologist evaluation takes hours (difficult child 1 had 10 hours, difficult child 2 had 8 hours) of testing and THEN the neuropsychologist comes to a diagnosis conclusion based on the results.
 

TerryJ2

Well-Known Member
The dr. kind of asked the same Q you did. He looked at the paperwork for the tests we already had done. He was not impressed... I think he said, "Oh, so it's just the psycho-social testing." ("Just" being the operative word.)

I know, he may have jumped the gun, but some of this is a combo of all the tests and clinical experience.
I plan to have more testing done. These tests may not be in the proper order, but as you know, you have to take the appts. when they come. I can always go back and/or get a 2nd opinion.

Interestingly, I discovered that diagnosis isn't just medical, it's philosopical. (Sort of like the discussions we've had here.) The dr commented that "Asperger's is very overdiagnosed." I immediately thought of that front page article a cpl wks ago where the headline read, "1 in 150 children said to be autistic."
I thought, hmm... how much of this is true science and how much is that we're still learning about this stuff and won't really know for another 100 yrs?

So, yes, I'd like to have more testing done, especially since I noticed on one of the old tests that difficult child's IQ was only 97. I know he's way beyond that. Regular IQ tests aren't designed for kids who don't have proper brain integration. difficult child has had so much tutoring and has come such a long way in the past yr, I know his brain pathways have changed.
 

oceans

New Member
You did a great job diverting the explosion! That is good that you got Asperger's ruled out, but if he didn't think much of the other testing that was preciously done, then it would be good to have some more done that are up to date. It is always good to have a second opinion.
 

smallworld

Moderator
Why doesn't this neuropsychologist do testing? That's what neuropsychs do.

by the way, our neuropsychologist said Bipolar Disorder is overdiagnosed as well. That doesn't mean my kids don't have it (and it doesn't mean they have it either, but they're being treated as if they do).

I don't mean to burst your bubble, but I've learned not to rely on a diagnosis made after an hour appointment without any testing.
 

DazedandConfused

Well-Known Member
I'm in the middle of neuropsychologist testing with Son. Two hours so far. Next week, she's going to try 6 hours with many breaks. She's new in private practice, but used with work at a very well known university children's hospital. She was also recommended by the Neurologist I took Son to recently.

I'm paying for this out of pocket. 3 grand. Ouch. But, in order to get a neuropsychologist through the children's hospital I would have to wait a 6 to 10 months for an appointment I only had to wait a couple of weeks.Then, a year to hear the results. So, I decided to suck it up and pay. No vacation this summer, but oh well! Hopefully, we will have the results before summer. I'm especially concerned because he will be starting middle school.

The last time son had an IQ test he tested at an 85. Borderline. This was before medications. I know that he's higher than that, but has so many issues when it comes to taking any sort of test. neuropsychologist, and SD, are going to retest him.

neuropsychologist says she is beginning to see some strengths and weaknesses. So, we shall see. Aspie has been batted around. But, the social skills have always been the defining factor that exludes him. He's outgoing. Actually, too much outgoing to the point that it is inappropriate and even dangerous. It drives me up the wall, but difficult child just doesn't get it. neuropsychologist and Neurologist says that doesn't necessarily rule out AS, but let's get the results first.

Son is also prone to the hysterical laughing too. And he has no imagination. If he has to write a short paper, I have to lead him step by step. He struggles to come up with anything on his own.

But, if asked about himself, Son would have gladly shared about himself. He loves to be the center of attention.

Sounds like you handled the KFC situation well. I know son would have been very upset and would have gone on and on about it.

Second opinions are generally a good to get when you can. I look at it as being one more source of information because ultimately I make the decisions.
 

BusynMember

Well-Known Member
One hour of testing is not a good diagnosis, in my opinion. That sort of short-cut testing is NOT the norm for a neuropsychologist. I'm surprised he diagnosed or ruled out that quickly on such flimsy evidence. I'm with smallmom. I wouldn't take it as definitive. We had twelve hours of testing for my son before he determined Pervasive Developmental Disorder (PDD)-not otherwise specified. Since all Aspies/autistics are different, I'm not sure if he did an intensive enough testing regiment. My son is really chatty, but he's definitely Autism Spectrum Disorders (ASD). LOL...I asked my son why his friends were his friends and he said, "Huh? Why? I don't know. So they can help you out or something?" LOL. I'm in an autism group and the kids are all so different that I'd want the full nine yards of testing. Aspergers can actually never be ruled out as there is no test for it. Most Aspies have poor social skills, are rigid, obsess over certain topics (computers/videogames to the EXTREME--not normal, but EXTREME is common), often had a flat affect, and are sensitive to sensory stuff---most have anxiety, but I think the biggest criteria is very poor understanding of social interaction and social skills help A LOT. Aspies can be very social. The key is are they appropriately social? Do they know how to interact? Dot hey "get" unwritten social rules? Do they antagonize everyone or do they understand the unspoken social rules such as "we take turns talking" "we stay on topic" "we don't make silly noises and interrupt" "we don't bump into somebody while he's talking" "we listen to what the other person says and don't just talk about OUR special interest" etc. Many especially Aspies try hard to socialize, but they don't know how to do it. THAT is as big a sign as being non-sociable. I would want another opinion and I would never trust the SD to get autism right. Kids with concrete thinking and no imagination--I'd be suspicous of Autism Spectrum Disorders (ASD). My son had two wrong diagnosis. (ADHD/ODD then bipolar). These quirky kids often act so strange that they are labeled mentally ill when, in fact, they are neurologically impaired, and can really do well with the right kind of help. Often, they are misdiagnosed and don't get the help that could make the difference in their lives. Keep trying. It took us a while to get the right diagnosis., but we persisted. Go to a neuropsychologist who will do ALL the testing, not just talk to the child. That sounds unsound. Can't tell you how many "good" professional said son isn't on the autism spectrum. They were wrong. He is doing great since we got the right diagnosis. and, most importantly, the right interventions. I'd want more input from somebody who will go into more detail. JMO (with lots of experience though).
 

SuzyfromTexas

New Member
Terry,

Just want to reiterate what everyone else has said about neuropsychologist testing. My son was tested for about 8-10 hours (broken up in one week) and it cost us $1,500. We received a 25 page report upon completion.

I think around 10-15 tests were given to him specifically. Everything from IQ to block design testing to fine and gross motor testing. One interesting thing we found from the tests was the differences between his verbal IQ and non-verbal IQ scores.

Just wanted to share my experience with our Neropsych evaluation.
 

TerryJ2

Well-Known Member
Aspies can be very social. The key is are they appropriately social? Do they know how to interact? Dot hey "get" unwritten social rules? Do they antagonize everyone or do they understand the unspoken social rules such as "we take turns talking" "we stay on topic" "we don't make silly noises and interrupt" "we don't bump into somebody while he's talking" "we listen to what the other person says and don't just talk about OUR special interest" etc. Many especially Aspies try hard to socialize, but they don't know how to do it.
That's actually one of the best explanations I've seen.
My difficult child can control himself quite well on Adderal and even when not on it, understands and apologizes (quite often on his own) but says he can't help it... an ADHD indicator. He only antagonizes me. :frown:
The teachers say he's hyper and does the pencil tapping, foot tapping thing, speaks out of turn, etc. but the speaking out of turn is actually on topic.
He "gets" unwritten social rules in public and in other people's homes for the most part and acts out at home. Sometimes he comes home from an event and blows up the min. he comes in the door, like he's had it with-trying to control himself... sort of like when I've been running all day and people have been obnoxious and I have PMS, and I come in the door and throw myself on the bed and cry. People feel sorry for me because tears are appropriate but not for him because anger and violence scare people.

 

Marguerite

Active Member
The doctor not testing - to repeat tests already done is futile, if they were done recently. In fact, it's more than futile it's damaging because the subject ends up developing skills at doing tests. What we've seen, over and over - they will look at all the data collected, including past tests and their subscores, and IF they feel that some ground has not been covered they will test more deeply in some areas.

HOWEVER - to rule out Asperger's quite that soon is a bit unusual. Although from your description he really does sound very much on the ball, and I must admit he claims to have ruled it out and took more time in doing so, that I take in 'diagnosing' other people WITH Asperger's. And now even mother in law has joined the ranks of diagnostician - she has met a number of people we know and been able to tell me which ones are Pervasive Developmental Disorder (PDD) and which are not - not bad! I can confirm whether she's got it right from my own personal knowledge of those people's histories.

difficult child 3 is now a lot more on topic these days. difficult child 1 is now VERY on topic, he really does seem 'normal' until you ask him to do something while he's trying to do something else. Watching him go to pieces is highly illuminating, but happens rarely these days because he's got so good at controlling it.

And they do - the smarter they are, the quicker they pick up how to mask their condition. This applies to ADHD as well. I can look at husband now, and see ADHD for sure, but the likelihood of Asperger's as well, but an Asperger's that has been adapted to. Socially he's sometimes a little inappropriate, but usually only when his guard is down. ANd increasingly rarely lately, far more when we were younger. He's done what both my boys have done - sat and studied human behaviour, tried to understand it and mimic it.
In the same way that difficult child 1 sat for hours, day after day, studying cockatoos and lorikeets feeding in our backyard, they've all watched human behaviour.
In the recent film difficult child 1 played a rainbow lorikeet. Because he's studied them so thoroughly, his performance was uncanny. But difficult child 1 is definitely Aspie.

easy child 2/difficult child 2 has had Asperger's ruled out, but increasingly we're not so sure. It's when she's stressed that we see it most - this is typical. Despite an amazing brain, there are aspects to her development that seem to have been delayed.

Even difficult child 3 - definitely autistic, he scores moderate on the Pervasive Developmental Disorder (PDD) scale, but he is increasingly capable of a normal conversation - something I never thought I'd see. He can talk about how people feel, he now does have theory of mind, he's constantly trying to find the humour in a situation and is getting remarkably good at improvising humour very effectively. A dry wit, remarkably sophisticated. I suspect that like difficult child 1 he is doing this by using a remarkable memory for jokes like a huge database. I've seen difficult child 1 bouncing jokes and puns back and forth with a professional comedian (neighbour of ours) like a duel. My neighbour was rapidly losing his sense of humour as he was finding himself being outmatched by an Aspie. husband & I loved it!
A lot of their humour is visual - they have a strong, sometimes idiosyncratic mental picture and a very fluent way of describing it. They can 'see' jokes happening around them and are skilled at describing them effectively.

And yet they still qualify as Pervasive Developmental Disorder (PDD). They are complex, sometimes confusing but never, ever dull.
And I do think that a lot of what 'makes it' is their unusual way of visualising the world, and then describing it. When difficult child 3 was still struggling with language, he was in the car one day going fast with an open window. He shut the window to cut the draught because, he told us, "the wind is poking my eyes."

OK, I'm waffling a bit now, but what I'm trying to say - the label can help with understanding, but it's very easy to get the label wrong, especially with older kids and especially with bright, older kids. Testing can easily be over-done, and this also makes it easy for a child to fudge a test, without necessarily doing it on purpose. More detailed sub-tests can help, but it is the interpretation of these results that has the most bearing and is, unfortunately, the most subjective.
difficult child 1 was tested when he was 16 and he was able to 'beat' the test, simply by doing what he's learnt to do with that brain of his. And the testers were not vigilant, so did not pick up the ambiguity of their questions which led to him 'cheating' accidentally. "Write something for us," they told him. "We want to see how you write. Write us something. A story, maybe." But they didn't tell him he had to make it up - he thought they wanted to see his handwriting, so he wrote a lovely story about a dragon called Shen, and the boy who was his rider. Compared to his usual compositions it was flowing, picturesque, vivid and well-done. I put the improvement down to his having been on new medications. It was only a week or so later that he read me a bit more of the same story - from a book we had at home - and I asked him why he had not made up his own story.
"I didn't know I was supposed to," he told me. "I like that story, I wanted to share it with them."
He had the story in his memory and used that. But they had ruled out Asperger's at that appointment because he had expressed himself so well and so fluently, in writing.

It is really hard to assess kids like ours who can be so very different, but in subtle ways.

Marg
 

SRL

Active Member
I'm helping a friend through the process right now. 10 1/2 hours of neuropsychologist testing have been scheduled.

If there are AS traits present, usually that diagnosis wouldn't be ruled out so soon into the process. And it should include a written diagnostic test specifically for Asperger's such as the ASDS.

Quote: "difficult child said, "My friends are nice. We play baseball and video games. And we all hate to sing."

My eyebrows shot up when he said that. It was so obviously not an aspie answer."

Actually if you tune into adult AS forums you will find that there would be a wide range of answers for that question. Some are perfectly content to have little or no human contact. Others have a small circle of friends, usually with very similar interests. Others desire friendships and are incredibly frustrated because they lack the social skills to make that happen.

The one thing that you would want out of the appointment is that if he leans in the direction of AS but is not clinically diagnosable, to have that professionally recognized. This can be very helpful in terms of designing and obtaining services as well as sending you as a parent in a specific direction to look for help. Many kids with AS traits are helped by intervention strategies for AS even if they fall short of the criteria.
 

Hound dog

Nana's are Beautiful
Hmmmmm. T can be very social, most especially with adults. His social is just "off the mark" from the norm.

T would say much the same thing about his "friends". When referring to those his age if you probed enough (or knew him) it wouldn't take long to find out that T assumed they were his friends because they tolerated his presence while they played around or near him. Otherwise his friends were many years younger than T.

Kids on the spectrum are just as individual as everyone else.

Hugs
 

Fran

Former desparate mom
<span style='font-size: 11pt'>I don't know if your son is an Aspie or on the spectrum or not. I do know that both of my son's have had a neuropsychologist evaluation for different reasons. One with Aspie traits and one without. Both boys had different neuropsychs. One in a Children's Hospital and one in private practice. Both had over 7 hrs of testing broken up. There was a very involved written summary about what was rulled out and why. What were out of the realm of normal and why.

I would probably consider another neuropsychologist that has more experience with neuropsychologist testing and evaluating. Just because the statistics may be over blown doesn't mean my kid doesn't have it. It's not my kids job to deflate the published statistics. The dr.s. job is to evaluate and help create a treatment plan.
Hopefully a second opinion will concur with what your first said although I disagree with the idea of an aspie answer and non aspie answer. The range is pretty wide. Stereotypes usually don't work with kids on a spectrum. </span>
 

Nancy

Well-Known Member
Terry I'm so impressed with how you handled your son in the lunch situation.

I regards to this neuropsychologist, it sounds like you have a lot of confidence in him and that's great. I'm not sure why all the second guessing but I do think it's important for you to finish the testing he requested and see what the final outcome is and what the treatments are before disregarding his adice as not thorough enough. I believe we can sense those professionals who speak from knowledge as opposed to those who talk to hear themselves talk.

Good luck in putting one more piece fo the puzzle into place. by the way some of his behaviors can be adoption issues also and those may not surface for a couple more years.

Nancy
 

TerryJ2

Well-Known Member
Marg, I love lorikeets! LOL.

Kind of spooky about the short story. I mean, did he write it word-for-word? And it's a perfect example of how people miss things.

You have come SUCH a long way with-your kids!!!! :laugh: :grin: :smile:

I've got a new book on Asperberger's that is very good. (I'll look up the name... it's in the car.) I can see similarities to my difficult child but when I went through their checklist, I only checked off 3 of 15 items. The others were in the "sometimes" category. Sigh.

I think the referral we got will help.

 

Marguerite

Active Member
Yep. What difficult child 1 wrote was almost completely word for word.

The other test they did where he accidentally fudged it was a test for short-term memory recall. I really worry about his short-term memory. It's basically the 'holding' memory, where you slot things like the phone number you've just looked up to dial, or the adddress, or a series of instructions. he can only hold one thing at a time unless we go slowly. In this test they read out a series of numbers with increasing numbers of digits. Beginning with, say, a five digit number they read it out as "3 - 5 - 7 - 2 - 3" with about a second between each digit. He then had to tell them back each series of numbers. Because it had been delivered slowly, he could do it. His response was slow, but accurate. I was frustrated because they hadn't picked up what we observe regularly - the mental confusion and total forgetting of multiple step instructions, plus the anxiety it produces in him.

It was about six months after the assessment that he came up to me and said, "What was that test where they read the numbers to me for? I mean, why did they want the numbers back in the same order they gave them to me? it would have been so much easier to give them the numbers in the reverse order."
He then rattled off a couple of the numbers he'd been given to explain what he meant. basically, as each digit was read to him he had enough time to slot it into his long-term memory, before the next digit was given. But to access his long-term memory he was using last number in, first number out. Then he had to put it back again in reverse order, so he could finally utter the whole sequence as he had been given them, which was as they were requested. This was why he had been MUCH slower (but still accurate) in his delivery, right up to nine digit numbers.

Because he has learned to compensate by using his long-term memory, he has an amazing storage and has a developed a moderately fast method of accurate recall. His deficit seems to be in short-term memory, but he has now a facet of his long term memory which compensates, mostly without problem. If things are flying at him too fast he goes to pieces and withdraws, but this is happening less and less. It is more obvious in a distracting, noisy environment. Interesting, husband is like this too. And also, husband has an amazing store of knowledge with good recall. Mine used to be as good, but not since my disability which has also affected cognitive function. All the family members are highly visual - my memory is connected with visual cues too - at work I would be asked where something in particular was located and I would give the room number, the cupboard location, the shelf in the cupboard and also what was nearby. I could even do a rough inventory or stocktake, using this recall. Definitely not now!

Whatever is decided in the label for your son, if you act as though he has the Aspie diagnosis it is a start, even if it is ruled out. When Asperger's was ruled out for easy child 2/difficult child 2 we tried to go back to normal expectations for her. Now she is 20 we can see that she is not normal. Mind you, most people do not see what we do, because she can hold things together moderately well and only goes to pieces fully where she feels safe. She's developed ways to escape and hide while still being socially acceptable - a fight with the boss can send her to the loo but she won't show tears until she's inside with the door locked. And she will wash her face and reapply make-up before she leaves the bathroom. She's mostly learned to not react even when she's angry, but if she's still angry when she gets home, the slightest little thing will produce the tantrum that she had to bite back at work. it has to come out somewhere, some time and it's better that we get it, than she lose her job for bursting into tears in front of customers.
Because she's a check-out chick she can successfully avoid all but fleeting eye contact. By keeping busy she needn't make eye contact although she's OK with people she knows. As a result, the pediatrician (who she feels comfortable with) will not diagnose Asperger's, although easy child 2/difficult child 2 herself wants to challenge him on this. Not that it matters now - she's getting all the support she needs at college anyway, and employers don't care. They only want to see how well she works.

Bur we've gone back to treating her as a high-functioning Aspie, and we're all getting on much better. She is also back to making more independent decisions, so we sometimes forget that she needs more than the average 20 year old.

She's upset that we're going to NZ without her. At first it was "I want a holiday too - why did you book it for while I would be in college?" but underneath, the real problem is "I'm scared to be on my own at home."
So now we know the real problem we don't say, "Don't be silly - you're an adult now, you should be looking ahead to living on your own, this will be good practice for you," we say, "BF2 will be here, and if he's not you can go and stay with Grandma, who probably will be lonely and needs someone to help her look after herself in our absence."
It may be extra stress to stay with Grandma, but easy child 2/difficult child 2 welcomed the suggestion because she knows she will be frightened on her own and will happily take on the extra burden, so as not to be alone.

Our kids take longer to mature, but they DO get there. And they have to get there - otherwise we will be carers for life, with live-in patients.

Marg
 
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