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<blockquote data-quote="rlsnights" data-source="post: 421892" data-attributes="member: 7948"><p>Well, first thing - I would dump that family doctor and the pediatrician. You do need a pediatrician in my opinion. But you need one who gets mental health issues in children. Clearly that one does NOT.</p><p></p><p>With a family history of bipolar and this behavior - well it just screams for further evaluation in my opinion. If it were just at home I could kind of see waiting but if she's being kicked out of preschool for aggressive and out of control behavior, now including running away??? How do you spell malpractice? </p><p></p><p>Have you done any mood charting over an extended period of time? If not, I would start that right away. You want to track both up and down each day rather than try to give an overall number to the day. If you want more advice on tracking, just ask. I would suggest tracking up and down moods/energy levels, sleep and naps (how long and what times), level of irritability, whether she got sent home that day, any medical issues like illness or antibiotics, any special events like travel out of town or birthday parties. Whatever you think will help and that are particular difficult or hallmark behaviors.</p><p></p><p>Next, I strongly suggest you get a neuropsychologist evaluation of your little girl. This is a comprehensive assessment of intellectual, emotional and developmental aspects. Often takes 8 to 10 hours of assessment plus interviews before and discussion of results after the assessment. $$$ typically $1,000 to $2,000 if you have to pay for it yourself. Ideally it should be paid for by your health insurance. Given the difficulties you have had getting referrals I expect you are going to continue to have trouble and may want to try to find a way to pay for this yourself or get help from grandparents/relatives maybe. It may be the best money you have ever spent or will spend for quite some time.</p><p></p><p>The developmental pediatrician may be helpful but they are usually focused on identifying autism and that does not sound like it is the issue here. Her relatively normal social development as you describe it is atypical of kids on the spectrum. That doesn't mean she doesn't have some spectrum issues or has an atypical presentation. Just cautioning you not to count on that assessment to be comprehensive enough to give you good info.</p><p></p><p>You can also look at taking her for evaluation by a CHILD psychiatrist (psychiatrist). A psychiatrist can diagnose and prescribe medications if that seems appropriate. Frankly, if she's running away from school at age 4 you are probably going to be faced with that decision really quickly. psychiatrist's are not any good usually at helping you with behavioral measures or practical stuff like school. They just don't have time. </p><p></p><p>You are absolutely entitled to an evaluation for special education services from your public school district, assuming you live in the US. She is old enough that she would be assessed through the public school rather than early intervention. You get that by writing a letter to the special education department asking for an assessment and stating the things that concern you and why you believe your daughter is going to need help in order to benefit from a free and appropriate public education. The school's assessment will be focused on the school's priorities and should not take the place of a neuropsychologist assessment.</p><p></p><p>It sounds like you are taking the realistic measures some families resist in dealing with your little difficult child. Many families find that they cannot have both parents work outside the home and that close supervision is always necessary. High school is harder if anything than the early grades. Sorry to break that to you.</p><p></p><p>Has she actually been tested for celiacs? Are you certain that her diet is truly gluten-free? I know this can be very hard to accomplish and some people are much more sensitive than others. The University of Chicago has a fantastic program and website about celiac's that you might want to check out.</p><p></p><p>Welcome to the board. Sorry you needed to look but glad you found us.</p><p></p><p>Patricia</p></blockquote><p></p>
[QUOTE="rlsnights, post: 421892, member: 7948"] Well, first thing - I would dump that family doctor and the pediatrician. You do need a pediatrician in my opinion. But you need one who gets mental health issues in children. Clearly that one does NOT. With a family history of bipolar and this behavior - well it just screams for further evaluation in my opinion. If it were just at home I could kind of see waiting but if she's being kicked out of preschool for aggressive and out of control behavior, now including running away??? How do you spell malpractice? Have you done any mood charting over an extended period of time? If not, I would start that right away. You want to track both up and down each day rather than try to give an overall number to the day. If you want more advice on tracking, just ask. I would suggest tracking up and down moods/energy levels, sleep and naps (how long and what times), level of irritability, whether she got sent home that day, any medical issues like illness or antibiotics, any special events like travel out of town or birthday parties. Whatever you think will help and that are particular difficult or hallmark behaviors. Next, I strongly suggest you get a neuropsychologist evaluation of your little girl. This is a comprehensive assessment of intellectual, emotional and developmental aspects. Often takes 8 to 10 hours of assessment plus interviews before and discussion of results after the assessment. $$$ typically $1,000 to $2,000 if you have to pay for it yourself. Ideally it should be paid for by your health insurance. Given the difficulties you have had getting referrals I expect you are going to continue to have trouble and may want to try to find a way to pay for this yourself or get help from grandparents/relatives maybe. It may be the best money you have ever spent or will spend for quite some time. The developmental pediatrician may be helpful but they are usually focused on identifying autism and that does not sound like it is the issue here. Her relatively normal social development as you describe it is atypical of kids on the spectrum. That doesn't mean she doesn't have some spectrum issues or has an atypical presentation. Just cautioning you not to count on that assessment to be comprehensive enough to give you good info. You can also look at taking her for evaluation by a CHILD psychiatrist (psychiatrist). A psychiatrist can diagnose and prescribe medications if that seems appropriate. Frankly, if she's running away from school at age 4 you are probably going to be faced with that decision really quickly. psychiatrist's are not any good usually at helping you with behavioral measures or practical stuff like school. They just don't have time. You are absolutely entitled to an evaluation for special education services from your public school district, assuming you live in the US. She is old enough that she would be assessed through the public school rather than early intervention. You get that by writing a letter to the special education department asking for an assessment and stating the things that concern you and why you believe your daughter is going to need help in order to benefit from a free and appropriate public education. The school's assessment will be focused on the school's priorities and should not take the place of a neuropsychologist assessment. It sounds like you are taking the realistic measures some families resist in dealing with your little difficult child. Many families find that they cannot have both parents work outside the home and that close supervision is always necessary. High school is harder if anything than the early grades. Sorry to break that to you. Has she actually been tested for celiacs? Are you certain that her diet is truly gluten-free? I know this can be very hard to accomplish and some people are much more sensitive than others. The University of Chicago has a fantastic program and website about celiac's that you might want to check out. Welcome to the board. Sorry you needed to look but glad you found us. Patricia [/QUOTE]
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