Now What? Need Advice on Who to see next...

Discussion in 'General Parenting' started by JulienSam, Apr 24, 2008.

  1. JulienSam

    JulienSam New Member

    A brief recap:
    12/07 Sam diagnosed with a mood disorder by social worker at local children pysch. practice
    2/08 Sam received diagnosis of ODD from psychiatric. Dept. of local children's hospital
    4/08 School district completes their evaluation of Sam & we have our case conference meeting (yesterday)

    I'll get to the case conference in a minute, but need help in figuring out who to see/what to do before school starts in the fall. WE need help now. Our regular pediatrician referred me to a couple of children's psychiatrists; one is retiring; the other two are in the same practice together & the practice's policy is that the first mtg. is with a social worker. I'd rather not have to go through the whole evaluation thing again so soon (it's not like his behavior has changed that much in the past couple of months)... so should I pursue see one of these child psychiatrists? I need to find someone who will work with us as a family, helping husband & I gain the tools necessary to best deal with Sam, and who can also work with Sam, one on one, if that would help.

    Re: the case conference... I am SO pleased with our evaluation team for the early childhood centers! Out of all the "professionals" we've seen, they've spent the most amount of time with him, and actually spent 2+ hours at his preschool observing him. While they aren't quite convinced that he's ODD, they do say he had a number of common characteristics of ODD, but they also saw quite bit of anxiety in him. Their testing supported the behaviors we already knew about (so it's kind of nice to know we're not crazy in the things we've seen), and confirmed that he is a very bright boy who has extreme impulse problems, and language issues when it comes to stressful situations.

    Sam qualified for an IEP with an emotional disability, and husband & I agreed with the goals set out for the fall. Sam will get 90 minutes a week of pull-out time (which could be either with a small group or individually) from a gen ed class, and another 60 min. a week one-on-one. I was very pleased to hear about the large play room built in the building, which is often used to allow kids on the verge of a meltdown to go to to blow off steam & cool down, and that they prefer to pull a child from a classroom as a meltdown starts to preserve the kid's dignity (yea!!!), as well as keep from disrupting the class. (This has been a HUGE problem in his preschool class -- there's not enough resources to pull him out of the room as a meltdown starts, and no place to take him, so he worries about the backlash from his classmates).

    The Asst. Principal for the school attended the meeting so that she's familiar with Sam's case in order to help assign an appropriate teacher for him. Everyone at the meeting (the school psychologist, Asst. Principal & head resource teacher) were all very open, friendly & stressed the importance of constant communication.

    I know this is their job, but it seemed to me that they genuinely cared about Sam & his kindergarten experience, and were willing to put a lot of time into this process. I'm thankful to have had such a positive experience, esp. after reading so many horror stories on other posts about conflicts with school.:D

    A part of me is HUGELY relieved to know that they're prepared for him in the fall, and that he'll have supports in place to help him succeed.

    However, they had few ideas on what we can do over the summer or right now with Sam -- which brings me back to my original question of what now?:confused:

  2. smallworld

    smallworld Moderator

    Can you describe specifically the kind of language issues he has?

    Has he had a private speech and language evaluation?

    Has he had a private Occupational Therapist (OT) evaluation to look at sensory issues?

    This is all pertinent to the bigger question of who you should see next.
  3. JulienSam

    JulienSam New Member

    He's has his speech evaluated by a private therapist & a school therapist who was part of the school district's evaluation team. No problems were noted except for his r, l sounds, which are developmentally appropriate.

    The language issues are more with his brain locking up when stressed/angered, and reacting physically instead of verbally. I.E., instead of asking for a toy, he'll grab it from a classmate or when told "no" by me, hitting me.

    He also has problems seeing or interpreting social cues from others appropriately.

    The IEP calls for the school's Occupational Therapist (OT) to evaluate him in the fall, and the team members gave a couple of suggestions of things to use in the meantime to help calm or avert his anger (stress balls, large exercise ball to bounce on).

    We're certainly open to having a private Occupational Therapist (OT) evaluation now...

  4. smallworld

    smallworld Moderator

    Hi Julie, I hope SRL comes along soon and confirms or refines what I'm going to recommend.

    I personally wouldn't trust a diagnosis made by a social worker. Mood disorders should really be diagnosed by a board-certified child psychiatrist (some may disagree with me, but I have three children with various flavors of mood disorders and all other mental health professionals missed what was truly going on with them). I also wouldn't trust a diagnosis of ODD made by anyone in a child this young. It is obvious that your son exhibits oppositional behavior (like most of the kids on this board), but ODD rarely stands alone and I strongly suspect another disorder is fueling his oppositional behavior.

    I know you don't want to go through another evaluation -- you've already been through so much -- but I'm not sure you've really nailed what's going on with Sam. With anxiety, impulse control challenges, language issues and lagging social skills (and smarts!), I think you need to rule in or out Autistic Spectrum Disorder. Psychiatrists frequently miss Autism Spectrum Disorders (ASD) so I would recommend an evaluation with a developmental pediatrician, a neuropsychologist or a multidisciplinary team at a children's or university teaching hospital. You could also call your local Autism Society and see who the staff would recommend as a good local specialist to see.

    It sounds as if you have a very caring school team. Way To Go on advocating for Sam's needs!