What should I expect for an ADHD Evaluation?

[butterfly31972]

Please tell me what I should expect at an ADHD evaluation?

I have an appointment Wednesday with difficult child's pediatrician to discuss the possibilty of his having this. The questionnaires have been filled out by myself, my husband, and his teachers. Two letters of recommendation also have been written.

I was kinda wondering what to expect as far as questions and I have his paperwork as far back as his Early Intervention evaluation when he was almost two and was recommended for speech therapy. I remember them writing" Child tries to control his household with his tantrums". I had only had him a few months at this point as a foster placement! I remember being so shocked by that statement.

Now he has been adopted for a year and next week will be his fourth year anniversary of coming to live with us. He is now 5 1/2.

Thanks for any advice and help in advance.

 

[smallworld]

I suspect that you may by looking at something beyond ADHD, given that your difficult child has speech delays, social issues and tantrums. So I'm wondering why you're limiting your evaluation to ADHD?

Furthermore, pediatricians are not qualified to diagnosis childhood disorders of a neurological or psychological nature. A neuropsychological or multidisciplinary evaluation at a children's or university teaching hopsital would be your best bet at getting a clearer picture of what's going on with your difficult child. You could certainly ask your pediatrician for a referral at Wednesday's appointment.

 

[BusynMember]

If he is from the foster care system, as my son was, he was likely exposed to drugs/alcohol prenatally. Likely, much more is going on besides ADHD. I wouldn't evaluate her for only ADHD. With the speech and social delays you could well be looking at somthing beyond that. Many kids test positive for ADHD, but there is actually more going on. Frankly, I'd see a neuropsychologist. You could be looking at Autism Spectrum Disorders (ASD) (autistic spectrum disorder) or fetal alcohol effects or a number of learning disabilities that a pediatrician is not really trained to evaluate. My son tested for ADHD, but he was on the autism spectrum, high functioning. I highly recommend a more intensive evaluation and not restricting yourself to one disorder. Again, I recommend a neuropsychologist--they just do more intensive testing and tend to get to the root of the matter far more than other professionals who just do fast evaluations and hand out medication. Good luck.

 

[butterfly31972]

Thanks smallworld and midwest mom.I am taking him to the doctor for this because the teacher asked me to have him evaluated for ADHD. The bio mom has refused to admit drug use and so I have nothing to go on there. I assume there was some drug use since she was a pretty wild child when she got pregnant with him at sixteen--had spent some time in a Residential Treatment Facility (RTF) at age 13.

 

[smallworld]

When you go to the appointment Wednesday, I recommend telling the pediatrician that the teacher suggested an ADHD evaluation, but because you suspect it may go beyond ADHD, you would like a referral for a more intensive evaluation that would rule in or out many childhood disorders (for example, Autism Spectrum Disorders (ASD), Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE), learning disabilities, anxiety, depression, etc).

 

[TerryJ2]

Butterfly, we didn't get our initial ADHD diagnosis from our pediatrician. He refused to acknowledge it, saying he had boys of his own.

He retired, and we moved to the next in line (literally, down the hallway). He refused, too, until difficult child needed a shot. That's when the fireworks began, and it was more than ADHD. difficult child screamed, tried to hide under the chair and desk (he was way too big to fit), threw things in the dr's ofc, then flung open the door (hurting the dr's elbow), ran down the hall and hid. A nurse found him quite a while later. (And yes, we had to hold him down for the shot but there was no way I was going home with-o it.)

The dr was aghast and said he hadn't seen anything like that b4. I sure hope he meant he hadn't seen it in my kid, and not that he hadn't seen it in his practice, or I'd wonder if he'd been living in a cave, treating only PCs.
At any rate, since we were going to counseling anyway, I just got the child psychiatric to fax a note to the pediatrician so we could get our difficult child on Adderal.
The neuropsychologist appointment came later.

All this is to say, don't get your hopes up too high. You can be armed with-paperwork but some doctors just don't "get it."

 

[busywend]

The pediatrician doctor will compare the answers and determine based on the 'score' if your difficult child shows signs of ADHD.

I agree that no matter what the pediatrician doctor says you should ask for a further evaluation since you already see the behavioral issues as well as possible hyperactivity.

 

[BusynMember]

I've adopted six kids in all. Three kids were out of foster care. Two were older (ages 11 and 7 when we got them) and too damaged and dangerous to live in a family. One came young, like your two came to you young, and he iis here, and doing great, but his ADHD turned out to be Autism Spectrum Disorders (ASD). Foster children are complicated. Lucas was first dxd. as ADHD/ODD. That was NOT the problem. His issues were similar to your daughter's, although he no longer ever rages due to good help and interventions.

Speech delays can be autism and if these kids are biologically related, that runs in families as well. You really should check it out--you can't do any harm by a total evaluation, but not doing one for BOTH kids can set them back big time. Please evaluate these little ones. They probably had a very rough prenatal history. You don't need the birthmother to confess to what she did. You have your own common sense.

It is really best for our foster/adopted kids to get extremely intensive evaluations because so much can be going on. Teachers can tell if something is wrong, but they really don't know what it is. They aren't trained to know. The teachers have heard of ADHD so they bring it up. No matter what, I'd take it further.

There are a lot of things it could be (for BOTH kids) and I'd do the neuropsychologist. The pediatrician simply is not going to know if something beyond that is going on and not finding out is a disservice to both of your children. Neither can be adquately helped if they aren't completely evaluated. It would be a rare foster child who only gets away with having ADHD. Most have much more going on. It isn't that easy to lose custody of your kids. Birthmother must really have mental health or neurological issues herself or she'd have her kids. Good luck

 

[butterfly31972]

UPDATE: Well, when I went in the pediatrician, who knows him, said that he is definitely showing signs of ADHD and ODD; but that he is too young for him to medicate at this time. So I have to wait until he has been in a mainstream kindergarten for six months, see how he does, then we can talk again about medication. He read the evaluations and questionnaires from the teachers and us and wants to wait. He did not suggest a psychiatric evaluation at this point.

I am kind of used to the way he acts and was surprised that the teachers in his special needs class were so adamant about him needing the ADHD evaluation and I told the doctor that they do not feel he can handle a mainstream class with out being medicated. But he said wait, so I will.
I kinda admire the fact that he did not pull out his prescription pad and write me a prescription right then and there. But he is the one who diagnoses and prescribes those such things in that particular office. It is a big practice and I like that they can handle most of our issues in that office.
Midwest mom, I guess I will have to find out how to get a full evaluation some other way.

 

[4sumrzn]

Our family physician sent us to a Neurologist (we still go there)....he sent us to a Psychologist...she sent us to a Psychiatrist....and now we have been sent to Cincinnati Children's Hospital to start all over again with full evaluations all around & all put together from the same place (all of difficult child's past evaluations have been from different places). This is 4 years later. These evaluations will not be completed until the end of the year. I would suggest intense evaluations....sooner rather than later. It may also take weeks/months to get in at the specialized places. Good luck

 

[butterfly31972]

OKAY 4SUMRZN, thanks for the info. I guess I will have to go more in depth is what you are saying? We always just did early intervention services and such; not this much in depth. I guess I need to know how to go about this??! Thanks in advance.

 

[totoro]

I know it is confusing! But I would never let a Pediatrician diagnosis or prescribe a serious medication for a behaviour or disorder... only as an emergency refill, or when working in tandem with my psychiatrist.
When we were looking for answers, our pediatrician sent us first to an Occupational Therapist (OT) for a sensory evaluation then the following week we were to start on a Nuero-psychiatric evaluation.
She said she would never if at all possible ever diagnosis or medicate a child either, medicate only if absolutely neccessary.
Unfortunately far too many pediatrician's are diagnosis'ing kids with serious issues when they do not have the qualifications to do so. If it is not ADHD, your child could be missing out on treatment that he could really use.
If it is just ADHD, maybe medications could help him. At 5 yo if he is struggling, why not? Home life matters also. JMO
Hang in there

 

[butterfly31972]

Thanks Totoru. I called the institution for developmental disabilties and they do not take my insurance. So I guess I will have to find a child psychologist who specializes in children with special needs.